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Incremental diagnostic value of color-coded virtual non-calcium dual-energy CT for the assessment of traumatic bone marrow edema of the scaphoid

Research output: Contribution to journalJournal articlepeer-review

  1. Quantifying the bone marrow composition of the healthy adult wrist with dual-energy CT

    Research output: Contribution to journalJournal articlepeer-review

  2. Kommentar til: Lungeembolus hos en patient med COVID-19

    Research output: Other contributionCommunication

  • Vitali Koch
  • Felix Christoph Müller
  • Kasper Gosvig
  • Moritz H. Albrecht
  • Ibrahim Yel
  • Lukas Lenga
  • Simon S. Martin
  • Marco Cavallaro
  • Julian L. Wichmann
  • Christoph Mader
  • Tommaso D’Angelo
  • Silvio Mazziotti
  • Giuseppe Cicero
  • Thomas J. Vogl
  • Christian Booz
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OBJECTIVES: To investigate the diagnostic accuracy of color-coded dual-energy CT virtual non-calcium (VNCa) reconstructions for the assessment of bone marrow edema (BME) of the scaphoid in patients with acute wrist trauma.

METHODS: Our retrospective study included data from 141 patients (67 women, 74 men; mean age 43 years, range 19-80 years) with acute wrist trauma who had undergone third-generation dual-source dual-energy CT and 3-T MRI within 7 days. Eight weeks after assessment of conventional grayscale dual-energy CT scans for the presence of fractures, corresponding color-coded VNCa reconstructions were independently analyzed by the same six radiologists for the presence of BME. CT numbers on VNCa reconstructions were evaluated by a seventh radiologist. Consensus reading of MRI series by two additional radiologists served as the reference standard.

RESULTS: MRI depicted 103 scaphoideal zones with BME in 76 patients. On qualitative analysis, VNCa images yielded high overall sensitivity (580/618 [94%]), specificity (1880/1920 [98%]), and accuracy (2460/2538 [97%]) for assessing BME as compared with MRI as reference standard. The interobserver agreement was excellent (κ = 0.98). CT numbers derived from VNCa images were significantly different in zones with and without edema (p < 0.001). A cutoff value of - 46 Hounsfield units provided a sensitivity of 91% and specificity of 97% for differentiating edematous scaphoid lesions. Receiver operating characteristic curve analysis revealed an overall area under the curve of 0.98.

CONCLUSIONS: Qualitative and quantitative analyses showed excellent diagnostic accuracy of color-coded VNCa reconstructions for assessing traumatic BME of the scaphoid compared to MRI.

KEY POINTS: • Color-coded virtual non-calcium (VNCa) reconstructions yield excellent diagnostic accuracy in assessing bone marrow edema of the scaphoid. • VNCa imaging enables detection of non-displaced fractures that are occult on standard grayscale CT. • Diagnostic confidence is comparable between VNCa imaging and MRI.

Original languageEnglish
JournalEuropean Radiology
Issue number7
Pages (from-to)4428-4437
Number of pages10
Publication statusPublished - Jul 2021

Bibliographical note

Publisher Copyright:
© 2021, European Society of Radiology.

    Research areas

  • Adult, Aged, Aged, 80 and over, Bone Marrow/diagnostic imaging, Calcium, Edema/diagnostic imaging, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Scaphoid Bone/diagnostic imaging, Sensitivity and Specificity, Tomography, X-Ray Computed, Young Adult

ID: 74732747