Dual-energy computed tomography (DECT) is a recent development for detecting bone marrow edema (BME) in patients with vertebral compression fractures.  The aim of this pilot study was to determine the reliability of single-source DECT in detecting vertebral BME using magnetic resonance imaging (MRI) as standard of reference.


 Nine patients with radiographic thoracic or lumbar vertebral compression fractures underwent both, DECT on a 320-row single-source scanner and 1.5T MRI.  Virtual non-calcium (VNC) images were reconstructed from the DECT volume datasets.  Fourteen target vertebrae with a radiographic height loss were identified; eight of them showed BME on MRI, while DECT identified BME in 7 instances.  Interrater agreement was inferior for DECT (κ=0.63-0.89) compared to MRI (κ=0.9-1.0).  Detecting BME with single-source DECT is feasible and allows detection of vertebral compression fractures with reasonably high sensitivity and specificity.  Nonetheless, DECT might accelerate the diagnostic work-flow in patients with vertebral compression fractures in the future and reduce the number of additional MRI examinations.
DECT
The aim of this pilot study was to determine the reliability of single-source DECT in detecting vertebral BME using magnetic resonance imaging (MRI) as standard of reference.


 Nine patients with radiographic thoracic or lumbar vertebral compression fractures underwent both, DECT on a 320-row single-source scanner and 1.5T MRI.  Fourteen target vertebrae with a radiographic height loss were identified; eight of them showed BME on MRI, while DECT identified BME in 7 instances.  Interrater agreement was inferior for DECT (κ=0.63-0.89) compared to MRI (κ=0.9-1.0).  Nonetheless, DECT might accelerate the diagnostic work-flow in patients with vertebral compression fractures in the future and reduce the number of additional MRI examinations.
MRI