Keywords:
Neuroradiology spine, Musculoskeletal spine, Conventional radiography, Absorptiometry / Bone densitometry, Diagnostic procedure, Observer performance, Comparative studies, Metabolic disorders, Demineralisation-Bone, Osteoporosis
Authors:
A. Bazzocchi1, F. Fuzzi1, P. Spinnato1, D. Diano1, G. Guglielmi2, C. Sassi1, G. Battista1, E. Salizzoni1; 1Bologna/IT, 2Foggia/IT
DOI:
10.1594/ecr2012/C-1943
Methods and Materials
Sixty-eight patients were prospectively enrolled in the study (38 males and 30 females; age 58.1±9.6 years old,
range 32-83 years).
Lateral spine images were obtained with densitometric and radiographic techniques on the same day by an expert technologist.
Images of the spine were independently evaluated by three radiologists with different experience (10, 5 and 3 years) in skeletal imaging.
The T4-L4 segment of the spine was the target of our analysis.
The designed diagnostic approach was based on VSQ,
as described by Genant et al.,
with complementary morphometric analysis when VFs were suspected on radiographs or DXA images.
All the three physicians involved in the study anonymously read radiographs and DXA studies in two sessions with at least 7 days between evaluations of images of the same patients.
The most expert physician repeated the analysis in a further reading session.
Sensitivity,
specificity and accuracy of VFA in the detection of VFs (or fractured patients) were calculated considering results from expert XR evaluation as gold standard.
Accuracy was expressed by means of the area under the receiver operating characteristic (ROC) curve (AUC) ± standard error of the means (SEM).
Intra- and inter-observer agreement was evaluated by means of the Cohen kappa statistic.