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Tomosynthesis of the thoracic spine: added value in diagnosing vertebral fractures in the elderly
Department of Radiology, Örebro University, Örebro, Sweden; Department of Clinical Sciences, Lund University, Lund, Sweden.
Department of Medical Imaging and Physiology, Lund University, Lund, Sweden; Skåne University Hospital, Lund, Sweden.
Department of Medical Imaging and Physiology, Lund University, Lund, Sweden; Skåne University Hospital, Lund, Sweden.
Department of Radiation Physics, Skåne University Hospital, Lund, Sweden.
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2017 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 27, no 2, 491-497 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly.

Methods: Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55-92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose-area product values.

Results: For all observers significantly more vertebrae were seen with tomosynthesis than with radiography (mean 12.4/9.3, P < 0.001) as well as significantly more fractures (mean 0.9/0.7, P = 0.017). The image quality score for tomosynthesis was significantly higher than for radiography, for all evaluated structures. Tomosynthesis took longer to evaluate than radiography. Despite this, all observers scored a clear preference for tomosynthesis. Observer agreement was substantial (mean κ = 0.73, range 0.51-0.94). The calibration or conversion factor was 0.11 mSv/(Gy cm(2)) for the combined examination. The resulting effective dose was 0.87 mSv.

Conclusion: Tomosynthesis can increase the detection rate of thoracic vertebral fractures in the elderly, at low added radiation dose.

KEY POINTS:• Tomosynthesis helps evaluate the thoracic spine in the elderly. • Observer agreement for thoracic spine tomosynthesis was substantial (mean κ = 0.73). • Significantly more vertebrae and significantly more fractures were seen with tomosynthesis. • Tomosynthesis took longer to evaluate than radiography. • There was a clear preference among all observers for tomosynthesis over radiography.

Place, publisher, year, edition, pages
New York: Springer, 2017. Vol. 27, no 2, 491-497 p.
Keyword [en]
Thoracic vertebrae, radiography, tomography, X-ray, image quality, fracture
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:oru:diva-50617DOI: 10.1007/s00330-016-4392-5ISI: 000392142000007PubMedID: 27246721Scopus ID: 2-s2.0-84973129798OAI: oai:DiVA.org:oru-50617DiVA: diva2:934384
Available from: 2016-06-08 Created: 2016-06-08 Last updated: 2017-03-06Bibliographically approved

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