Purpose
Vertebral Compression Fractures (VCF) are brittle fractures that result from the deterioration of the bone structure, mainly when the anterior portion of the vertebra (the vertebral body) breaks and loses height, while the posterior portion is maintained [1,2]. Based on the percentage of vertebral height loss (VHL), fracture severity is characterized as grade 1 (20% - 25% collapse), grade 2 (26% - 40% collapse), or grade 3 (>40% collapse), according to the Genant semiquantitative classification scheme [3]. They are mostly caused by osteoporosis, but they...
Methods and materials
We retrospectively and consecutively collected all chest-abdominal-pelvis (CAP) CT scans, with and without contrast, performed for various medical reasons other than suspicion of VCF (cancer, HIV, neoplasia, infection, etc.) at Sainte-Marguerite Hospital (Marseille, France). All the patients were more than 50 years old. The cases were acquired from January 2019 to August 2020. Non-inclusion criteria corresponded to material in the vertebrae and significant artifacts.In order to establish the ground truth (GT), two board-certified radiologists analyzed the scans and defined by consensus the presence of VCF...
Results
A total of 100 opportunistic CT scans were included in the study. Mean age was 76.6 yo ± 10.1 [SD], 72% were women and 89% were contrast-enhanced CT exams. The ground truth identified 52 CT scans as positive for VCF.Regarding VCF screening, the comparison of CINA-VCF with the GT yielded a sensitivity of 92.3% [95% CI: 81.5% - 97.9%], a specificity of 91.7% [95% CI: 80.0% - 97.7%] and an accuracy of 92.0% [95% CI: 84.8% - 96.5%]. In terms of discrepancies, 3/4 of false...
Conclusion
The DL-based algorithm was capable of accurately labeling vertebrae and screening opportunistic VCF on real-world data. The device shows promising results in the automatic detection of VCF on scans acquired for other medical reasons. Indeed, the results matched with the expert visual assessments, considered as the GT.Such automatic diagnosis has many benefits. For instance, radiologists no longer need to perform the tedious task of screening for incidental findings. Saved time can be used to improve early diagnosis of osteoporosis, initiate treatment and predict future fragility...
Personal information and conflict of interest
M. Quemeneur:
Nothing to disclose
P. Champsaur:
Nothing to disclose
A. Ayobi:
Employee: Avicenna.AI, La Ciotat, France
C. Charlotte:
Employee: Avicenna.AI, La Ciotat, France
S. Quenet:
Employee: Avicenna.AI, La Ciotat, France
J. Kiewsky:
Employee: Avicenna.AI, La Ciotat, France
M. Mahfoud:
Employee: Avicenna.AI, La Ciotat, France
C. Avare:
Employee: Avicenna.AI, La Ciotat, France
D. Guenoun:
Nothing to disclose
References
[1] D. Alsoof, G. Anderson, C.L. McDonald, B. Basques, E. Kuris, A.H. Daniels, Diagnosis and Management of Vertebral Compression Fracture, Am. J. Med. 135 (2022) 815–821. https://doi.org/10.1016/j.amjmed.2022.02.035.[2] H.-B. Sun, X.-S. Jing, G.-Q. Zhang, Y. Hai, Y.-Z. Liu, D.-C. Wang, Preliminary Study of Obese Patients with Chronic Obstructive Pulmonary Disease Suffering from Painful Osteoporotic Vertebral Compression Fracture Treated by Percutaneous Vertebroplasty in Improved Prone Position and Right Lateral Position, World Neurosurg. 130 (2019) e933–e940. https://doi.org/10.1016/j.wneu.2019.07.040.[3] H.K. Genant, C.Y. Wu, C. van Kuijk, M.C. Nevitt, Vertebral fracture...