nach oben

Erschienen in:

16.11.2019 | Original Article

Automatic rib unfolding in postmortem computed tomography: diagnostic evaluation of the OpenRib software compared with the autopsy in the detection of rib fractures

verfasst von: Martin Kolopp, Nicolas Douis, Ayla Urbaneja, Cédric Baumann, Pedro Augusto Gondim Teixeira, Alain Blum, Laurent Martrille

Erschienen in: International Journal of Legal Medicine | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

Abstract

Objectives

The main objective of this study was to evaluate the diagnostic performance of the OpenRib software against the gold standard of autopsy in the detection of rib fractures. The secondary objective was to measure inter-rater agreement between each radiological reader.

Materials and methods

Thirty-six subjects who underwent postmortem CT and autopsy were included in this study. Rib fractures were first assessed during the autopsy by carefully dissecting and examining each rib. They were also independently evaluated by three readers using OpenRib software. This software produces from postmortem CT images a reformat of the rib cage and a display of all ribs in a single plane. Each reader was asked to determine if the rib was fractured and, if so, whether the fracture was single or multiple.

Results

After exclusions, 649 ribs were included in the statistical analysis. The two readers with a similar level of experience showed a satisfactory inter-rater agreement and a sensitivity of 0.73 and 0.83 with a specificity of 0.95 and 0.91. However, the experienced reader diagnosed significantly more fractures than the autopsy and the other two readers (p < 0.001).

Conclusion

The use of automatic rib unfolding software in postmortem CT allows an efficient and accurate assessment of rib fractures and enables the diagnosis of fractures that cannot be detected during a standard autopsy. For now, this method seems to be the simplest that can be routinely performed; however, it requires training time in order to be sufficiently effective.

Nur mit Berechtigung zugänglich

Kaewlai R, Avery LL, Asrani AV, Novelline RA (2008) Multidetector CT of blunt thoracic trauma. RadioGraphics 28:1555–1570. https://doi.org/10.1148/rg.286085510 CrossRefPubMed

Gondim Teixeira PA, Blum A (2017) Clinical application of musculoskeletal CT: trauma, oncology, and postsurgery. In: Medical radiology. Springer, Berlin, pp 1–27. https://doi.org/10.1007/174_2017_25 CrossRef

Homann G, Mustafa DF, Ditt H, Spengler W, Kopp HG, Nikolaou K, Horger M (2015) Improved detection of bone metastases from lung cancer in the thoracic cage using 5- and 1-mm axial images versus a new CT software generating rib unfolding images: comparison with standard 18F-FDG-PET/CT. Acad Radiol 22:505–512. https://doi.org/10.1016/j.acra.2014.12.005 CrossRefPubMed

Ha JY, Jeon KN, Bae K, Choi BH (2017) Effect of bone reading CT software on radiologist performance in detecting bone metastases from breast cancer. Br J Radiol 90:20160809. https://doi.org/10.1259/bjr.20160809 CrossRefPubMedPubMedCentral

Seuss H, Dankerl P, Cavallaro A, Uder M, Hammon M (2016) Osteoblastic lesion screening with an advanced post-processing package enabling in-plane rib reading in CT-images. BMC Med Imaging 16:39. https://doi.org/10.1186/s12880-016-0141-0 CrossRefPubMedPubMedCentral

Bier G, Mustafa DF, Kloth C, Weisel K, Ditt H, Nikolaou K, Horger M (2016) Improved follow-up and response monitoring of thoracic cage involvement in multiple myeloma using a novel CT postprocessing software: the lessons we learned. Am J Roentgenol 206:57–63. https://doi.org/10.2214/AJR.15.15089 CrossRef

Horger M, Ditt H, Liao S, Weisel K, Fritz J, Thaiss WM, Kaufmann S, Nikolaou K, Kloth C (2017) Automated “Bone Subtraction” image analysis software package for improved and faster CT monitoring of longitudinal spine involvement in patients with multiple myeloma. Acad Radiol 24:623–632. https://doi.org/10.1016/j.acra.2016.12.003 CrossRefPubMed

Bier G, Schabel C, Othman A, Bongers MN, Schmehl J, Ditt H, Nikolaou K, Bamberg F, Notohamiprodjo M (2015) Enhanced reading time efficiency by use of automatically unfolded CT rib reformations in acute trauma. Eur J Radiol 84:2173–2180. https://doi.org/10.1016/j.ejrad.2015.07.023 CrossRefPubMed

Ringl H, Lazar M, Töpker M, Woitek R, Prosch H, Asenbaum U, Balassy C, Toth D, Weber M, Hajdu S, Soza G, Wimmer A, Mang T (2015) The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures: effect on sensitivity and specificity in trauma patients. Eur Radiol 25:1865–1874. https://doi.org/10.1007/s00330-015-3598-2 CrossRefPubMed

10.

Dankerl P, Seuss H, Ellmann S, Cavallaro A, Uder M, Hammon M (2017) Evaluation of rib fractures on a single-in-plane image reformation of the rib cage in CT examinations. Acad Radiol 24:153–159. https://doi.org/10.1016/j.acra.2016.09.022 CrossRefPubMed

11.

Khung S, Masset P, Duhamel A, Faivre JB, Flohr T, Remy J, Remy-Jardin M (2017) Automated 3D rendering of ribs in 110 polytrauma patients: strengths and limitations. Acad Radiol 24:146–152. https://doi.org/10.1016/j.acra.2016.09.018 CrossRefPubMed

12.

Glemser PA, Pfleiderer M, Heger A, Tremper J, Krauskopf A, Schlemmer HP, Yen K, Simons D (2017) New bone post-processing tools in forensic imaging: a multi-reader feasibility study to evaluate detection time and diagnostic accuracy in rib fracture assessment. Int J Legal Med 131:489–496. https://doi.org/10.1007/s00414-016-1412-6 CrossRefPubMed

13.

Blum A, Kolopp M, Teixeira PG, Stroud T, Noirtin P, Coudane H, Martrille L (2018) Synergistic role of newer techniques for forensic and postmortem CT examinations. AJR Am J Roentgenol 211:1–8. https://doi.org/10.2214/AJR.17.19046 CrossRef

14.

Tobon-Gomez C, Stroud T, Cameron J, Elcock D, Murray A, Wyeth D, Conway C, Reynolds S, Teixeira PA, Blum A, Plakas C (2017) OpenRib clinical application. In: Computational methods and clinical applications in musculoskeletal imaging. Paper presented at MICCAI, Quebec City, 10 September (pp 35-45). Quebec City, Canada

15.

Tobon-Gomez C, Stroud T, Cameron J, Elcock D, Murray A, Wyeth D, Conway C, Reynolds S, Teixeira PA, Blum A, Plakas C (2018) Unfolded cylindrical projection for rib fracture diagnosis. In: Glocker B., Yao J., Vrtovec T., Frangi A., Zheng G. (eds) Computational methods and clinical applications in musculoskeletal imaging. MSKI 2017. Lecture Notes in Computer Science, vol 10734. Springer, Cham. pp. 36–47. https://doi.org/10.1007/978-3-319-74113-0_4 CrossRef

16.

Urbaneja A, De Verbizier J, Formery AS, Tobon-Gomez C, Nace L, Blum A, Gondim Teixeira PA (2019) Automatic rib cage unfolding with CT cylindrical projection reformat in polytraumatized patients for rib fracture detection and characterization: feasibility and clinical application. Eur J Radiol 110:121–127. https://doi.org/10.1016/j.ejrad.2018.11.011 CrossRefPubMed

17.

Love JC, Symes SA (2004) Understanding rib fracture patterns: incomplete and buckle fractures. J Forensic Sci 49:1153–1158CrossRef

18.

Daegling DJ, Warren MW, Hotzman JL, Self CJ (2008) Structural analysis of human rib fracture and implications for forensic interpretation. J Forensic Sci 53:1301–1307. https://doi.org/10.1111/j.1556-4029.2008.00876.x CrossRefPubMed

19.

Scheirs S, Langenhorst W, Malgosa A, Ortega-Sánchez M, McGlynn H, Santos C, Jordana X, Rodriguez-Baeza A, Galtés I (2018) Perimortem fracture pattern in ribs by blunt force trauma. Int J Legal Med 132:1205–1213. https://doi.org/10.1007/s00414-018-1806-8 CrossRefPubMed

20.

Yang K, Lynch M, O’Donnell C (2011) “Buckle” rib fracture: an artifact following cardio-pulmonary resuscitation detected on postmortem CT. Legal Med 13:233–239. https://doi.org/10.1016/j.legalmed.2011.05.004 CrossRefPubMed

21.

Schulze C, Hoppe H, Schweitzer W, Schwendener N, Grabherr S, Jackowski C (2013) Rib fractures at postmortem computed tomography (PMCT) validated against the autopsy. Forensic Sci Int 233:90–98. https://doi.org/10.1016/j.forsciint.2013.08.025 CrossRefPubMed

Titel: Automatic rib unfolding in postmortem computed tomography: diagnostic evaluation of the OpenRib software compared with the autopsy in the detection of rib fractures
verfasst von: Martin Kolopp
Nicolas Douis
Ayla Urbaneja
Cédric Baumann
Pedro Augusto Gondim Teixeira
Alain Blum
Laurent Martrille
Publikationsdatum: 16.11.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Legal Medicine / Ausgabe 1/2020
Print ISSN: 0937-9827
Elektronische ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-019-02195-x

Springer Medizin

Automatic rib unfolding in postmortem computed tomography: diagnostic evaluation of the OpenRib software compared with the autopsy in the detection of rib fractures

Abstract

Objectives

Materials and methods

Results

Conclusion

Neu im Fachgebiet Rechtsmedizin

Molekularpathologische Untersuchungen im Wandel der Zeit

Vergleichende Pathologie in der onkologischen Forschung

Gastrointestinale Stromatumoren

Personalisierte Medizin in der Onkologie

Springer Medizin

Abstract

Objectives

Materials and methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2020

Inter-laboratory study on standardized MPS libraries: evaluation of performance, concordance, and sensitivity using mixtures and degraded DNA

RNU6B, a frequent reference in miRNA expression studies, differentiates between deaths caused by hypothermia and chronic cardiac ischemia

MDPV-induced aggression in humans not established

Targeted molecular genetic testing in young sudden cardiac death victims from Western Denmark

The challenge of post-mortem GHB analysis: storage conditions and specimen types are both important

Estimation of the number of contributors to mixed samples of DNA by mitochondrial DNA analyses using massively parallel sequencing

Neu im Fachgebiet Rechtsmedizin

Molekularpathologische Untersuchungen im Wandel der Zeit

Vergleichende Pathologie in der onkologischen Forschung

Gastrointestinale Stromatumoren

Personalisierte Medizin in der Onkologie