3D CT versus axial helical CT versus conventional tomography in the classification of acetabular fractures: a ROC analysis.
OBJECTIVE
To assess the diagnostic power of three-dimensional computed tomography (3D CT), axial helical computed tomography (CT) and conventional tomography in the classification of acetabular fractures by interdisciplinary review.


METHODS
Receiver operating characteristics (ROCs) were assessed for two radiologists and two surgeons blinded to the presence of acetabular fractures in an animal model (a total of 62 porcine hips, 40 of them with artificial acetabular fractures). Main target parameter was the diagnostic accuracy in the classification of the artificial fractures following Judet et al.


RESULTS
ROC analysis for radiologists showed A(z) values of 0.83 for 3D CT, 0.81 for axial helical CT, and 0.78 for conventional tomography; differences between the three techniques were not significant (P = 0.46-0.73). A(z) values for the surgeons were 0.87 for 3D CT, 0.68 for axial helical CT, and 0.60 for conventional tomography; 3D CT was significantly better than axial helical CT (P = 0.01) and conventional tomography (P = 0.001). The differences between axial helical CT and conventional tomography were not significant (P = 0.37).


CONCLUSIONS
Acetabular fractures are best classified by 3D CT, followed by axial helical CT and conventional tomography when assessed by surgeons. 3D CT did not provide any additional significant benefit in the classification performed by radiologists.
Kickuth
Ralph
R
Department of Radiology, Marienhospital Herne, University of Bochum, Herne, Germany.
Laufer
Ulf
U
Hartung
Guido
G
Gruening
Christian
C
Stueckle
Christoph
C
Kirchner
Johannes
J
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries*; D000818:Animals; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D013502:General Surgery; D023421:Models, Animal; D011237:Predictive Value of Tests; D012372:ROC Curve; D011871:Radiology; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods*