Skeletal Radiology

, Volume 47, Issue 4, pp 491–504 | Cite as

Diagnostic accuracy of low-dose versus ultra-low-dose CT for lumbar disc disease and facet joint osteoarthritis in patients with low back pain with MRI correlation

  • Sun Hwa Lee
  • Seong Jong Yun
  • Hyeon Hwan Jo
  • Dong Hyeon Kim
  • Jae Gwang Song
  • Yong Sung Park
Scientific Article
  • 175 Downloads

Abstract

Objective

To compare the image quality, radiation dose, and diagnostic performance between low-dose (LD) and ultra-low-dose (ULD) lumbar-spine (L-spine) CT with iterative reconstruction (IR) for patients with chronic low back pain (LBP).

Methods

In total, 260 patients with chronic LBP who underwent L-spine CT between November 2015 and September 2016 were prospectively enrolled. Of these, 143 underwent LD-CT with IR and 117 underwent ULD-CT with IR. The patients were divided according to their body mass index (BMI) into BMI1 (<22.9 kg/m2), BMI2 (23.0–24.9 kg/m2), and BMI3 (≥25 kg/m2) groups. Two blinded radiologists independently evaluated the signal-to-noise ratio (SNR), qualitative image quality, and final diagnoses (lumbar disc disease and facet joint osteoarthritis). L-spine MRIs interpreted by consensus were used as the reference standard. All data were statistically analyzed.

Results

ULD protocol showed significantly lower SNR for all patients (p < 0.001) except the vertebral bodies and lower qualitative image quality for BMI3 patients (p ≤ 0.033). There was no statistically significant difference between ULD (sensitivity, 95.1–98.1%; specificity, 92.5–98.7%; accuracy, 94.6–98.0%) and LD protocols (sensitivity, 95.6–100%; specificity, 95.5–98.9%; accuracy, 97.4–98.1%), (all p≥0.1) in the BMI1 and BMI2; while dose was 60–68% lower with the ULD protocol. Interobserver agreements were excellent or good with regard to image quality and final diagnoses.

Conclusions

For the BM1 and BMI2 groups, ULD-CT provided an acceptable image quality and exhibited a diagnostic accuracy similar to that of LD-CT. These findings suggest that it is a useful diagnostic tool for patients with chronic LBP who exhibit a BMI of <25 kg/m2.

Keywords

Lumbar disc herniation Facet joint osteoarthritis Image quality Diagnostic performance Computed tomography 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human. Participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consents from each patient were obtained.

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Copyright information

© ISS 2017

Authors and Affiliations

  • Sun Hwa Lee
    • 1
  • Seong Jong Yun
    • 2
  • Hyeon Hwan Jo
    • 2
  • Dong Hyeon Kim
    • 2
  • Jae Gwang Song
    • 3
  • Yong Sung Park
    • 4
  1. 1.Department of Emergency Medicine, Sanggye Paik HospitalInje University College of MedicineNowon-guRepublic of Korea
  2. 2.Department of Radiology, Aerospace Medical CenterRepublic of Korea Air ForceCheongwon-gunRepublic of Korea
  3. 3.Department of Orthopedic Surgery, Aerospace Medical CenterRepublic of Korea Air ForceCheongwon-gunRepublic of Korea
  4. 4.Department of RadiologyKyung Hee University Hospital at Gangdong, Kyung Hee University School of MedicineSeoulRepublic of Korea

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