Universität zu Köln

Borggrefe, Jan ORCID: 0000-0003-2908-7560, Neuhaus, Victor-Frederic, Le Blanc, Markus, Hokamp, Nils Grosse, Maus, Volker, Mpotsaris, Anastasios ORCID: 0000-0002-1275-8164, Lennartz, Simon, dos Santos, Daniel Pinto, Maintz, David and Abdullayev, Nuran ORCID: 0000-0003-4522-537X (2019). Accuracy of iodine density thresholds for the separation of vertebral bone metastases from healthy-appearing trabecular bone in spectral detector computed tomography. Eur. Radiol., 29 (6). S. 3253 - 3262. NEW YORK: SPRINGER. ISSN 1432-1084

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Abstract

PurposeTo evaluate quantitative iodine density mapping (IDM) with spectral detector computed tomography (SDCT) as a quantitative biomarker for separation of vertebral trabecular bone metastases (BM) from healthy-appearing trabecular bone (HTB).Materials and methodsIRB-approved retrospective single-center-study of portal venous SDCT datasets acquired between June 2016 and March 2017. Inclusion of 43 consecutive cancer patients with BM and 40 without. Target lesions and non-affected control vertebrae were defined using follow-up imaging, MRI, and/or bone scintigraphy. ID and standard deviation were determined with ROI measures by two readers in (a) bone metastases, (b) HTB of BM patients and controls, and (c) ID of various vessels. Volumetric bone mineral density (vBMD) of the lumbar spine and age were recorded. Multivariate ROC analyses und Wilcoxon test were used to determine thresholds for separation of BM and HTB. p<0.05 was considered significant.ResultsID measurements of 40 target lesions and 83 reference measurements of HTB were acquired. Age (p<0.0001) and vBMD (p<0.05) affected ID measurements independently in multivariate models. There were significant differences of ID between metastases (n=43) and HTB ID (n=124; mean 5.50.9 vs. 3.50.9; p<0.0001), however, with considerable overlap. In univariate analysis, increased ID discriminated bone lesions (AUC 0.90) with a maximum combined specificity/sensitivity of 77.5%/90.7% when applying a threshold of 4.5mg/ml. Multivariate regression models improved significantly when considering vBMD, the noise of ID, and vertebral venous ID (AUC 0.98).ConclusionIDM of SDCT yielded a statistical separation of vertebral bone lesions and HTB. Adjustment for confounders such as age and lumbar vBMD as well as for vertebral venous ID and lesion heterogeneity improved discrimination of trabecular lesions.Key Points center dot SDCT iodine density mapping provides the possibility for quantitative analysis of iodine uptake in tissue, which allows to differentiate bone lesions from healthy bone marrow. Age and vBMD have a significant impact on iodine density measurements. Iodine density measured in SDCT yielded highest sensitivity and specificity for the statistical differentiation of vertebral trabecular metastases and healthy trabecular bone using an iodine density threshold of 4.5mg/ml (most performant)-5.0mg/ml (optimized for specificity).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED Neuhaus, Victor-Frederic UNSPECIFIED UNSPECIFIED UNSPECIFIED Le Blanc, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Mpotsaris, Anastasios UNSPECIFIED orcid.org/0000-0002-1275-8164 UNSPECIFIED Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED dos Santos, Daniel Pinto UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Abdullayev, Nuran UNSPECIFIED orcid.org/0000-0003-4522-537X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-147488
DOI:	10.1007/s00330-018-5843-y
Journal or Publication Title:	Eur. Radiol.
Volume:	29
Number:	6
Page Range:	S. 3253 - 3262
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1084
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL-ENERGY CT; BLOOD-FLOW; CANCER; TUMORS; ANGIOGENESIS; MECHANISMS; DIAGNOSIS; DISEASE; QUALITY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14748