Ha, Ji Y; Jeon, Kyung N; Bae, Kyungsoo; Choi, Bong H
The British journal of radiology
2017Apr ; 90 ( 1072 ) :20160809.
PMID : 28256905
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Ha, Ji Y -
Jeon, Kyung N -
Bae, Kyungsoo -
Choi, Bong H -
ABSTRACT
OBJECTIVE: To evaluate the effect of CT software that generates rib unfolding images and automatically numbers ribs and thoracic spines on radiologist performance in detecting thoracic bone metastases from breast cancer.
METHODS: A total of 126 patients with breast cancer who underwent chest CT and fludeoxyglucose (FDG)-positron emission tomography (PET)/CT and/or bone scans were retrospectively reviewed. One board-certified radiologist (R1) and one radiology resident (R2) independently assessed the original chest CT and rib unfolding images using a commercially available post-processing software (Bone Reading) application to evaluate metastasis in the ribs and thoracic spines. Results were compared with reference standard based on CT, FDG-PET/CT and/or bone scan with follow-up.
RESULTS: Based on reference standard, 78 metastatic bone lesions in 26 patients were identified. On per-patient-based analysis, Bone Reading assessed by R1/R2 had a sensitivity of 84.6%/80.8% and a specificity of 94.0%/94.0% with an accuracy of 92.1%/91.3%. The original CT reading yielded a sensitivity of 73.1%/57.7% and a specificity of 95.0%/94.0% with an accuracy of 90.5%/86.5%. The sensitivity and accuracy of Bone Reading were significantly higher than those of CT reading, as assessed by R2 (both p?=?0.031). On per-lesion-based analysis, Bone Reading assessed by R1/R2 yielded a sensitivity of 84.6%/82.1% and a specificity of 99.7%/99.6% with an accuracy of 99.4%/99.3%, while the original CT reading yielded a sensitivity of 71.8%/62.8% and a specificity of 99.6%/99.5% with an accuracy of 99.2%/98.9%. The sensitivity and accuracy with Bone Reading application were significantly higher than those with CT reading by both readers (R1, p?=?0.006 and p?=?0.036, respectively; R2, both p?
Adult; Aged; Bone Neoplasms/*diagnostic imaging/*secondary; Breast Neoplasms/*pathology; Female; Humans; Middle Aged; Reproducibility of Results; Retrospective Studies; Ribs/diagnostic imaging; Sensitivity and Specificity; Thoracic Vertebrae/diagnostic imaging; Tomography, X-Ray Computed/*methods
MESH
Adult, Aged, Bone Neoplasms/*diagnostic imaging/*secondary, Breast Neoplasms/*pathology, Female, Humans, Middle Aged, Reproducibility of Results, Retrospective Studies, Ribs/diagnostic imaging, Sensitivity and Specificity, Thoracic Vertebrae/diagnostic imaging, Tomography, X-Ray Computed/*methods
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