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01-03-2017 | Original Article

New bone post-processing tools in forensic imaging: a multi-reader feasibility study to evaluate detection time and diagnostic accuracy in rib fracture assessment

Authors: Philip A. Glemser, Michael Pfleiderer, Anna Heger, Jan Tremper, Astrid Krauskopf, Heinz-Peter Schlemmer, Kathrin Yen, David Simons

Published in: International Journal of Legal Medicine | Issue 2/2017

Abstract

Purpose

The aim of this multi-reader feasibility study was to evaluate new post-processing CT imaging tools in rib fracture assessment of forensic cases by analyzing detection time and diagnostic accuracy.

Materials and methods

Thirty autopsy cases (20 with and 10 without rib fractures in autopsy) were randomly selected and included in this study. All cases received a native whole body CT scan prior to the autopsy procedure, which included dissection and careful evaluation of each rib. In addition to standard transverse sections (modality A), CT images were subjected to a reconstruction algorithm to compute axial labelling of the ribs (modality B) as well as “unfolding” visualizations of the rib cage (modality C, “eagle tool”). Three radiologists with different clinical and forensic experience who were blinded to autopsy results evaluated all cases in a random manner of modality and case.

Results

Rib fracture assessment of each reader was evaluated compared to autopsy and a CT consensus read as radiologic reference. A detailed evaluation of relevant test parameters revealed a better accordance to the CT consensus read as to the autopsy. Modality C was the significantly quickest rib fracture detection modality despite slightly reduced statistic test parameters compared to modalities A and B.

Conclusion

Modern CT post-processing software is able to shorten reading time and to increase sensitivity and specificity compared to standard autopsy alone. The eagle tool as an easy to use tool is suited for an initial rib fracture screening prior to autopsy and can therefore be beneficial for forensic pathologists.

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Title: New bone post-processing tools in forensic imaging: a multi-reader feasibility study to evaluate detection time and diagnostic accuracy in rib fracture assessment
Authors: Philip A. Glemser
Michael Pfleiderer
Anna Heger
Jan Tremper
Astrid Krauskopf
Heinz-Peter Schlemmer
Kathrin Yen
David Simons
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Legal Medicine / Issue 2/2017
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-016-1412-6

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New bone post-processing tools in forensic imaging: a multi-reader feasibility study to evaluate detection time and diagnostic accuracy in rib fracture assessment

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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