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Tomosynthesis of the thoracic spine : added value in diagnosing vertebral fractures in the elderly

Geijer, Mats LU ; Gunnlaugsson, Eirikur LU ; Götestrand, Simon LU ; Weber, Lars LU and Geijer, Håkan (2017) In European Radiology 27(2). p.491-497
Abstract

Objectives: Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly. Methods: Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55–92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose–area product values. Results: For all observers significantly more vertebrae were seen with... (More)

Objectives: Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly. Methods: Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55–92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose–area product values. Results: For all observers significantly more vertebrae were seen with tomosynthesis than with radiography (mean 12.4/9.3, P <0.001) as well as significantly more fractures (mean 0.9/0.7, P = 0.017). The image quality score for tomosynthesis was significantly higher than for radiography, for all evaluated structures. Tomosynthesis took longer to evaluate than radiography. Despite this, all observers scored a clear preference for tomosynthesis. Observer agreement was substantial (mean κ = 0.73, range 0.51–0.94). The calibration or conversion factor was 0.11 mSv/(Gy cm2) for the combined examination. The resulting effective dose was 0.87 mSv. Conclusion: Tomosynthesis can increase the detection rate of thoracic vertebral fractures in the elderly, at low added radiation dose. Key Points: • Tomosynthesis helps evaluate the thoracic spine in the elderly.• Observer agreement for thoracic spine tomosynthesis was substantial (mean κ = 0.73).• Significantly more vertebrae and significantly more fractures were seen with tomosynthesis.• Tomosynthesis took longer to evaluate than radiography.• There was a clear preference among all observers for tomosynthesis over radiography.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Fracture, Image quality, Radiography, Thoracic vertebrae, Tomography, X-ray
in
European Radiology
volume
27
issue
2
pages
491 - 497
publisher
Springer
external identifiers
  • pmid:27246721
  • wos:000392142000007
  • scopus:84973129798
ISSN
0938-7994
DOI
10.1007/s00330-016-4392-5
language
English
LU publication?
yes
id
f7eef6d9-e2af-44ed-9d43-5bcfe52944c2
date added to LUP
2016-06-22 09:56:53
date last changed
2022-05-02 04:04:57
@article{f7eef6d9-e2af-44ed-9d43-5bcfe52944c2,
  abstract     = {{<p>Objectives: Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly. Methods: Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55–92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose–area product values. Results: For all observers significantly more vertebrae were seen with tomosynthesis than with radiography (mean 12.4/9.3, P &lt;0.001) as well as significantly more fractures (mean 0.9/0.7, P = 0.017). The image quality score for tomosynthesis was significantly higher than for radiography, for all evaluated structures. Tomosynthesis took longer to evaluate than radiography. Despite this, all observers scored a clear preference for tomosynthesis. Observer agreement was substantial (mean κ = 0.73, range 0.51–0.94). The calibration or conversion factor was 0.11 mSv/(Gy cm<sup>2</sup>) for the combined examination. The resulting effective dose was 0.87 mSv. Conclusion: Tomosynthesis can increase the detection rate of thoracic vertebral fractures in the elderly, at low added radiation dose. Key Points: • Tomosynthesis helps evaluate the thoracic spine in the elderly.• Observer agreement for thoracic spine tomosynthesis was substantial (mean κ = 0.73).• Significantly more vertebrae and significantly more fractures were seen with tomosynthesis.• Tomosynthesis took longer to evaluate than radiography.• There was a clear preference among all observers for tomosynthesis over radiography.</p>}},
  author       = {{Geijer, Mats and Gunnlaugsson, Eirikur and Götestrand, Simon and Weber, Lars and Geijer, Håkan}},
  issn         = {{0938-7994}},
  keywords     = {{Fracture; Image quality; Radiography; Thoracic vertebrae; Tomography; X-ray}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{491--497}},
  publisher    = {{Springer}},
  series       = {{European Radiology}},
  title        = {{Tomosynthesis of the thoracic spine : added value in diagnosing vertebral fractures in the elderly}},
  url          = {{https://lup.lub.lu.se/search/files/13533833/8687974.pdf}},
  doi          = {{10.1007/s00330-016-4392-5}},
  volume       = {{27}},
  year         = {{2017}},
}