title: Identification of prevalent vertebral fractures using CT lateral scout views: a comparison of semi-automated quantitative vertebral morphometry and radiologist semi-quantitative grading.
abstract: We compared vertebral fracture assessment by semi-automated quantitative vertebral morphometry measurements with the conventional semi-quantitative (SQ) grading using lateral CT scout views. The semi-automated morphometry method showed good to excellent agreement with the visual SQ grading by radiologists for identification of vertebral fractures.
  
  
  BACKGROUND
  Semi-automated quantitative vertebral morphometry (QM) measurements may enhance management of osteoporosis patients by providing an efficient means to identify vertebral fractures (VFx). We compared identification of prevalent VFx by semi-automated QM to SQ grading.
  
  
  METHODS
  A non-radiologist performed semi-automated QM from CT lateral scout views in 200 subjects (102 men, 98 women, 65.8 ± 8.9 years) selected from the Framingham Heart Study Multidetector CT Study. VFx were classified in the QM approach based on using Genant's criteria for deformities, and compared with conventional SQ grading performed by experienced radiologists as the gold standard. The kappa (k) statistics, percent agreement (% Agree), sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were computed.
  
  
  RESULTS
  Among 200 subjects, 57 had mild and 41 had moderate or severe VFx by visual SQ grading. Per-person analyses showed excellent agreement between the two methods, with k = 0.780. The % Agree ranged from 86.7% to 91.2%, the SE was 81.3%-96%, and the SP was 86.5%-92%. Among 2,588 vertebrae analyzed, 107 had mild and 49 had moderate or severe VFx by visual SQ grading. Per-vertebra analyses revealed good agreement, with k = 0.580. Agreement between the methods tended to be highest in L1-L4 region. Agreement and validity measures were higher when only moderate and severe fractures were included.
  
  
  CONCLUSIONS
  The semi-automated quantitative vertebral morphometry measurements from CT lateral scout views provided good to excellent agreement with the standard SQ grading for assessment of prevalent vertebral fractures.
authors.affiliation: Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Y M
authors.initials: YM
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Demissie
authors.forename: H K
authors.initials: HK
authors.lastname: Genant
authors.forename: X
authors.initials: X
authors.lastname: Cheng
authors.forename: W
authors.initials: W
authors.lastname: Yu
authors.forename: E J
authors.initials: EJ
authors.lastname: Samelson
authors.forename: D P
authors.initials: DP
authors.lastname: Kiel
authors.forename: M L
authors.initials: ML
authors.lastname: Bouxsein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012737:Sex Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000473:pathology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D014057:Tomography, X-Ray Computed / Q000379:methods