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Skeletal Radiology
Published in: Skeletal Radiology 7/2015

01-07-2015 | Scientific Article

Improvement of diagnostic confidence for detection of multiple myeloma involvement of the ribs by a new CT software generating rib unfolded images: Comparison with 5- and 1-mm axial images

Authors: Georg Homann, Katja Weisel, Deedar Farhad Mustafa, Hendrik Ditt, Konstantin Nikolaou, Marius Horger

Published in: Skeletal Radiology | Issue 7/2015

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Abstract

Objective

To investigate the performance of a new CT software generating rib unfolded images for improved detection of rib osteolyses in patients with multiple myeloma.

Materials and methods

One hundred sixteen patients who underwent whole-body reduced-dose multidetector computed tomography (WBRD-MDCT) for multiple myeloma diagnosis and during follow-up were retrospectively evaluated. Nonenhanced CT scans with 5- and 1-mm slice thickness were interpreted by two readers with focus on detection of rib involvement (location, number, fracture). Image analysis of “unfolded,” 1-mm-based CT rib images was subsequently undertaken. We classified the number of lytic bone lesions into 0, 1, 2, <5, <10 and ≥10. For all three data sets the reading time was registered.

Results

An approximated sum of 6,727 myeloma-related rib lesions was found. On a patient-based analysis, CT (5 mm), CT (1 mm) and CT (1 mm “unfolded rib”) yielded a sensitivity, specificity and accuracy of 79.7/94.7/87.1, 88.1/93/90.5 and 98.3/96.5/97.4, respectively. In a lesion-based analysis, the sensitivity, specificity and accuracy of the three evaluations were 69.7/87.2/70.5, 79.8/55.9/78 and 96.5/89.7/96.1. Mean reading time for 5 mm/1 mm axial images and unfolded images was 178.7/215.1/90.8 s, respectively.

Conclusion

The generation of “unfolded rib” images improves detection of rib involvement in patients with multiple myeloma and significantly reduces reading time.
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Metadata
Title
Improvement of diagnostic confidence for detection of multiple myeloma involvement of the ribs by a new CT software generating rib unfolded images: Comparison with 5- and 1-mm axial images
Authors
Georg Homann
Katja Weisel
Deedar Farhad Mustafa
Hendrik Ditt
Konstantin Nikolaou
Marius Horger
Publication date
01-07-2015
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 7/2015
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-015-2131-7

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