Burns Joseph E, Yao Jianhua, Muñoz Hector, Summers Ronald M
From the Department of Radiological Sciences, University of California-Irvine, Orange, Calif (J.E.B.); and Imaging Biomarkers and Computer-Aided Detection Laboratory, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, 10 Center Dr, Building 10, 1C224, MSC1182, Bethesda, MD 20892-1182 (J.Y., H.M., R.M.S.).
Radiology. 2016 Jan;278(1):64-73. doi: 10.1148/radiol.2015142346. Epub 2015 Jul 14.
To design and validate a fully automated computer system for the detection and anatomic localization of traumatic thoracic and lumbar vertebral body fractures at computed tomography (CT).
This retrospective study was HIPAA compliant. Institutional review board approval was obtained, and informed consent was waived. CT examinations in 104 patients (mean age, 34.4 years; range, 14-88 years; 32 women, 72 men), consisting of 94 examinations with positive findings for fractures (59 with vertebral body fractures) and 10 control examinations (without vertebral fractures), were performed. There were 141 thoracic and lumbar vertebral body fractures in the case set. The locations of fractures were marked and classified by a radiologist according to Denis column involvement. The CT data set was divided into training and testing subsets (37 and 67 subsets, respectively) for analysis by means of prototype software for fully automated spinal segmentation and fracture detection. Free-response receiver operating characteristic analysis was performed.
Training set sensitivity for detection and localization of fractures within each vertebra was 0.82 (28 of 34 findings; 95% confidence interval [CI]: 0.68, 0.90), with a false-positive rate of 2.5 findings per patient. The sensitivity for fracture localization to the correct vertebra was 0.88 (23 of 26 findings; 95% CI: 0.72, 0.96), with a false-positive rate of 1.3. Testing set sensitivity for the detection and localization of fractures within each vertebra was 0.81 (87 of 107 findings; 95% CI: 0.75, 0.87), with a false-positive rate of 2.7. The sensitivity for fracture localization to the correct vertebra was 0.92 (55 of 60 findings; 95% CI: 0.79, 0.94), with a false-positive rate of 1.6. The most common cause of false-positive findings was nutrient foramina (106 of 272 findings [39%]).
The fully automated computer system detects and anatomically localizes vertebral body fractures in the thoracic and lumbar spine on CT images with a high sensitivity and a low false-positive rate.
设计并验证一种用于在计算机断层扫描(CT)中检测和解剖定位创伤性胸腰椎椎体骨折的全自动计算机系统。
本回顾性研究符合健康保险流通与责任法案(HIPAA)。获得了机构审查委员会的批准,并豁免了知情同意。对104例患者(平均年龄34.4岁;范围14 - 88岁;女性32例,男性72例)进行了CT检查,其中包括94例有骨折阳性发现的检查(59例椎体骨折)和10例对照检查(无椎体骨折)。病例组中有141例胸腰椎椎体骨折。放射科医生根据Denis柱受累情况对骨折部位进行标记和分类。将CT数据集分为训练子集和测试子集(分别为37个和67个),通过用于全自动脊柱分割和骨折检测的原型软件进行分析。进行了自由响应接收器操作特征分析。
训练集对每个椎体内骨折检测和定位的敏感性为0.82(34个发现中的28个;95%置信区间[CI]:0.68,0.90),每位患者的假阳性率为2.5个发现。骨折定位到正确椎体的敏感性为0.88(26个发现中的23个;95%CI:0.72,0.96),假阳性率为1.3。测试集对每个椎体内骨折检测和定位的敏感性为0.81(107个发现中的87个;95%CI:0.75,0.87),假阳性率为2.7。骨折定位到正确椎体的敏感性为0.92(60个发现中的55个;95%CI:0.79,0.94),假阳性率为1.6。假阳性发现最常见的原因是滋养孔(272个发现中的106个[39%])。
该全自动计算机系统在CT图像上对胸腰椎椎体骨折进行检测和解剖定位,具有高敏感性和低假阳性率。