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Automatic detection of osteoporotic vertebral fractures in routine thoracic and abdominal MDCT

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To develop a prototype algorithm for automatic spine segmentation in MDCT images and use it to automatically detect osteoporotic vertebral fractures.

Methods

Cross-sectional routine thoracic and abdominal MDCT images of 71 patients including 8 males and 9 females with 25 osteoporotic vertebral fractures and longitudinal MDCT images of 9 patients with 18 incidental fractures in the follow-up MDCT were retrospectively selected. The spine segmentation algorithm localised and identified the vertebrae T5-L5. Each vertebra was automatically segmented by using corresponding vertebra surface shape models that were adapted to the original images. Anterior, middle, and posterior height of each vertebra was automatically determined; the anterior-posterior ratio (APR) and middle-posterior ratio (MPR) were computed. As the gold standard, radiologists graded vertebral fractures from T5 to L5 according to the Genant classification in consensus.

Results

Using ROC analysis to differentiate vertebrae without versus with prevalent fracture, AUC values of 0.84 and 0.83 were obtained for APR and MPR, respectively (p < 0.001). Longitudinal changes in APR and MPR were significantly different between vertebrae without versus with incidental fracture (ΔAPR: -8.5 % ± 8.6 % versus -1.6 % ± 4.2 %, p = 0.002; ΔMPR: -11.4 % ± 7.7 % versus -1.2 % ± 1.6 %, p < 0.001).

Conclusions

This prototype algorithm may support radiologists in reporting currently underdiagnosed osteoporotic vertebral fractures so that appropriate therapy can be initiated.

Key points

• This spine segmentation algorithm automatically localised, identified, and segmented the vertebrae in MDCT images.

• Osteoporotic vertebral fractures could be automatically detected using this prototype algorithm.

• The prototype algorithm helps radiologists to report underdiagnosed osteoporotic vertebral fractures.

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Acknowledgements

The authors thank Thomas Netsch, PhD, for supporting the MDCT data management.

The scientific guarantor of this publication is Jan S. Bauer, MD. The authors of this manuscript declare relationships with the following companies: Tobias Klinder, PhD, and Cristian Lorenz, PhD, are employees of Philips. This study received funding by the Deutsche Forschungsgemeinschaft (DFG BA 4085/1-2 (to J.S.B.), BA 4085/2-1 (to J.S.B.), and BA 4906/1-1 (to T.B.)). No complex statistical methods were necessary for this article. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, case-control study, performed at one institution.

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Authors and Affiliations

  1. Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Germany

    Thomas Baum, Martin Dobritz, Ernst J. Rummeny & Peter B. Noël

  2. Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Germany

    Jan S. Bauer

  3. Philips Research Laboratories, Röntgenstr. 24, 22335, Hamburg, Germany

    Tobias Klinder & Cristian Lorenz

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  1. Thomas Baum
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  2. Jan S. Bauer
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Correspondence to Thomas Baum.

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Baum, T., Bauer, J.S., Klinder, T. et al. Automatic detection of osteoporotic vertebral fractures in routine thoracic and abdominal MDCT. Eur Radiol 24, 872–880 (2014). https://doi.org/10.1007/s00330-013-3089-2

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  • DOI: https://doi.org/10.1007/s00330-013-3089-2

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