title: Automated detection of sclerotic metastases in the thoracolumbar spine at CT.
abstract: To design and validate a computer system for automated detection and quantitative characterization of sclerotic metastases of the thoracolumbar spine on computed tomography (CT) images.
  
  
  
  This retrospective study was approved by the institutional review board and was HIPAA compliant; informed consent was waived. The data set consisted of CT examinations in 49 patients (14 female, 35 male patients; mean age, 57.0 years; range, 12-77 years), demonstrating a total of 532 sclerotic lesions of the spine of greater than 0.3 cm(3) in volume, and in 10 control case patients (four women, six men; mean age, 55.2 years; range, 19-70 years) without spinal lesions. CT examinations were divided into training and test sets, and images were analyzed according to prototypical fully-automated computer-aided detection (CAD) software. Free-response receiver operating characteristic analysis was performed.
  
  
  
  Lesion detection sensitivity on images in the training set was 90%, relative to reference-standard marked lesions (95% confidence interval [CI]: 83%, 97%), at a false-positive rate (FPR) of 10.8 per patient (95% CI: 6.6, 15.0). For images in the testing set, sensitivity was 79% (95% CI: 74%, 84%), with an FPR of 10.9 per patient (95% CI: 8.5, 13.3). False-negative findings were most commonly (37 [40%] of 93) a result of endplate proximity, with 32 (34% of 93) caused by low CT attenuation. Marginal sclerosis caused by degenerative change (174 [28.1%] of 620 actual detections) was the most common cause of false-positive detections, followed by partial volume averaging with vertebral endplates (173 [27.9%] of 620) and pedicle cortex parallel to the axial imaging plane (121 [19.5%] 620).
  
  
  
  This CAD system successfully identified and segmented sclerotic lesions in the thoracolumbar spine.
authors: Department of Radiological Sciences, University of California-Irvine, Orange, Calif, USA.
authors: Joseph E
authors: JE
authors: Burns
authors: Jianhua
authors: J
authors: Yao
authors: Tatjana S
authors: TS
authors: Wiese
authors: Hector E
authors: HE
authors: Muñoz
authors: Elizabeth C
authors: EC
authors: Jones
authors: Ronald M
authors: RM
authors: Summers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D016022:Case-Control Studies; D002648:Child; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007472:Iohexol; D007479:Iopamidol; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; D007479:Iopamidol