title: Enhanced reading time efficiency by use of automatically unfolded CT rib reformations in acute trauma.
abstract: Rationale of this study was to evaluate whether unfolded rib images enhance time efficiency in detection of rib fractures and time efficiency in patients with acute thoracic trauma. 51 subsequent patients with thoracic trauma underwent 64-slice computed tomography. 1mm thick axial slices were reformatted using a commercially available post-processing software application generating rotatable unfolded rib images. Diagnostic accuracy was evaluated by 3 readers and compared to multiplanar reformations of the original CT images. Reformation and evaluation times were recorded. 116 rib fractures were detected. The multiplanar reformation analysis yielded a sensitivity of 87.9%/93.9%/79.7% with a specificity of 97%/97%/82.2%, whilst the unfolded rib image analysis yielded a sensitivity of 94.8%/94.8%/92.2% and a specificity of 85.2/87.8%/82.4 (p=0.06/0.8/0.04) with high inter-observer agreement (k=0.79-0.85). The mean reading time for the multiplanar reformations was significantly longer (reader 1: 103.7 ± 27.1s/reader 2: 81.8 ± 40.6s/reader 3: 154.3 ± 39.2s) than the evaluation of the unfolded rib images (19.4 ± 4.9s/26.9 ± 15.0s/49.9 ± 18.7s; p<0.01). Concluding, the unfolded rib display reduces reading time for detection of rib fractures in acute thoracic trauma patients significantly and does not compromise the diagnostic accuracy significantly in experienced radiologists. However, unexperienced readers may profit from use of this display.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, D-72074 Tübingen, Germany. Electronic address: georg.homann@med.uni-tuebingen.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Bier
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, D-72074 Tübingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schabel
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, D-72074 Tübingen, Germany.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Othman
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, D-72074 Tübingen, Germany.
authors.forename: Malte N
authors.initials: MN
authors.lastname: Bongers
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, D-72074 Tübingen, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Schmehl
authors.affiliation: Siemens AG, Healthcare Sector Imaging & Therapy Division, Siemensstr. 1, D-91301 Forchheim, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Ditt
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, D-72074 Tübingen, Germany.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, D-72074 Tübingen, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Bamberg
authors.affiliation: Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tübingen, Hoppe-Seyler-Str. 3, D-72074 Tübingen, Germany.
authors.forename: Mike
authors.initials: M
authors.lastname: Notohamiprodjo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005409:Flail Chest / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012253:Rib Fractures / Q000000981:diagnostic imaging*; D012272:Ribs / Q000293:injuries / Q000473:pathology*; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Computer-assisted; Image processing; Multidetector computed tomography; Rib fractures; Sensitivity and specificity; Thoracic injuries