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Eur Radiol. 2014 Apr;24(4):872-80. doi: 10.1007/s00330-013-3089-2. Epub 2014 Jan 15.

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

Author information

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

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.

PMID:
24425527
DOI:
10.1007/s00330-013-3089-2
[Indexed for MEDLINE]

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