Korean Journal of Radiology

  • 제22권12호
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  • Pages.2026-2033
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  • 2021
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Digital Tomosynthesis versus Conventional Radiography for Evaluating Osteonecrosis of the Femoral Head

  • Yun Hwa Roh (Department of Radiology, Hanyang University Hospital, College of Medicine, Hanyang University) ;
  • Seunghun Lee (Department of Radiology, Hanyang University Hospital, College of Medicine, Hanyang University) ;
  • Jeong Ah Ryu (Department of Radiology, Hanyang University Guri Hospital, College of Medicine, Hanyang University) ;
  • Yeo Ju Kim (Department of Radiology, Hanyang University Hospital, College of Medicine, Hanyang University) ;
  • Yeesuk Kim (Department of Orthopaedic Surgery, Hanyang University Hospital, College of Medicine, Hanyang University) ;
  • Jiyoon Bae (Department of Pathology, National Police Hospital)
  • 투고 : 2021.01.18
  • 심사 : 2021.06.28
  • 발행 : 2021.12.01
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초록

Objective: The aim of this study was to compare the diagnostic performances of digital tomosynthesis (DTS) and conventional radiography in detecting osteonecrosis of the femoral head (ONFH) using computed tomography (CT), as the reference standard and evaluate the diagnostic reproducibility of DTS. Materials and Methods: Forty-five patients (24 male and 21 female; age range, 25-77 years) with clinically suspected ONFH underwent anteroposterior radiography, DTS, and CT. Two musculoskeletal radiologists independently evaluated the presence and type of ONFH. The diagnostic performance of radiography and DTS in detecting the presence of ONFH and determining the types of ONFH were evaluated. The interobserver and intraobserver reliabilities of each imaging modality were analyzed using Cohen's kappa. Results: DTS had higher sensitivity (89.4%-100% vs. 74.5%-76.6%) and specificity (97.3%-100% vs. 78.4%-83.8%) for ONFH detection than radiography. DTS showed higher performance than radiography in identifying the subtypes of ONFH with statistical significance in one reader (type 1, 100% vs. 30.8%, p = 0.004; type II, 97.1% vs. 73.5%, p = 0.008). The interobserver agreement was excellent for DTS and moderate for radiography (kappa of 0.86 vs. 0.57, respectively). The intraobserver agreement for DTS was higher than that of radiography (kappa of 0.96 vs. 0.69, respectively). Conclusion: DTS showed higher diagnostic performance and reproducibility than radiography in detecting ONFH. DTS may be used as a first-line diagnostic modality instead of radiography for patients suspected of having ONFH.

키워드

과제정보

We thank Yun Jin Kim, Soorack Ryu in the Biostatistical Consulting and Research Lab, Hanyang University for assistance with statistical analysis.

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