Benjamin Fritz MD, Presenter: Nothing to Disclose

Jan Fritz MD, Abstract Co-Author: Research Grant, Siemens AG Research Consultant, Siemens AG

Maximilian Russe MD, Abstract Co-Author: Nothing to Disclose

Simon Leschka, Abstract Co-Author: Nothing to Disclose

Jakob Neubauer MD, Abstract Co-Author: Nothing to Disclose

Mathias F. J. Langer MD, PhD, Abstract Co-Author: Nothing to Disclose

Elmar C. Kotter MD, MSc, Abstract Co-Author: Editorial Advisory Board, Thieme Medical Publishers, Inc

The evaluation of computed tomography (CT) images for the presence of rib fractures can be time-consuming. The automated creation of unfolded, straight, two-dimensional CT maps of the rib cage with a commercially available curved planar reconstruction algorithm (syngo.CT Bone Reading, Siemens Healthcare, Erlangen, Germany) can potentially shorten interpretation time. Therefore, we compared the diagnostic performance and reading time of automated curved reconstruction CT maps and standard axial CT images for the detection of rib fractures.

Isotropic chest CT data sets of 41 trauma patients were used. 21 of 41 (51%) datasets contained 137 of 984 (14%) rib fractures, which were established through independent image interpretation of two experienced readers with subsequent consensus interpretation. For comparison of the two visualization techniques, three readers independently evaluated the data sets, which were randomly presented and blinded to time, date and patient information. Data evaluation was performed in two sessions, which were two weeks apart. In the first session, curved reconstruction CT maps were given for interpretation and axial CT images in the second session. Diagnostic performance statistics included sensitivity, specificity, and overall reliability. A general multilevel linear modelling framework was used to revise the data clustering and dependency. Non-parametric tests were used to assess differences. A p-value ≤ 0.05 was considered significant.

Using automated curved reconstruction CT maps, the sensitivity was 81-86%, specificity was 96-98%, and reliability was 94-96%. The mean reading time was 48-73 sec. Using axial CT images, the sensitivity was 85-90%, specificity was 97- 98% and reliability was 95-97%. The mean reading time was 91-112 sec. Comparison of the two different techniques on a reader-by-reader basis computed no statistical difference of the overall reliability (p = 0.7-0.063), whereas the mean reading times were statistically different for all readers (p ≤ .001).  

Automated curved reconstruction CT maps of ribs can shorten interpretation time needed for the detection of rib fractures with similar diagnostic performance of axial CT image interpretation.

Automated curved reconstruction CT maps of the ribs can shorten interpretation time needed for the detection of rib fracture and can increase efficiency of trauma CT interpretation.

Fritz, B, Fritz, J, Russe, M, Leschka, S, Neubauer, J, Langer, M, Kotter, E, Automated Curved versus Standard Axial Reconstruction CT Images of the Rib Cage—Comparison of Diagnostic Performance and Time Requirement for the Detection of Rib Fractures.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045600.html