Physiological iodine uptake of the spine’s bone marrow in dual-energy computed tomography – using artificial intelligence to define reference values based on 678 CT examinations of 189 individuals

Frontiers in Endocrinology

Endocrinology

Florian Fervers¹  Philipp Fervers²  Robert Reimer²  Erkan Celik²  David Zopfs²  Miriam Rinneburger²  Thorsten Persigehl²  Mathilda Weisthoff²  Jonathan Kottlors²  Nils Große-Hokamp²  David Maintz² 

[1] Fraunhofer Institute of Optronics, System Technologies and Image Exploitation IOSB, Karlsruhe, Germany;University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany;

关键词: bone marrow;    iodine;    reference values;    tomography;    X-Ray computed;    artificial Intelligence;   

DOI  :  10.3389/fendo.2023.1098898

 received in 2022-11-15, accepted in 2023-05-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

PurposeThe bone marrow’s iodine uptake in dual-energy CT (DECT) is elevated in malignant disease. We aimed to investigate the physiological range of bone marrow iodine uptake after intravenous contrast application, and examine its dependence on vBMD, iodine blood pool, patient age, and sex.MethodRetrospective analysis of oncological patients without evidence of metastatic disease. DECT examinations were performed on a spectral detector CT scanner in portal venous contrast phase. The thoracic and lumbar spine were segmented by a pre-trained neural network, obtaining volumetric iodine concentration data [mg/ml]. vBMD was assessed using a phantomless, CE-certified software [mg/cm3]. The iodine blood pool was estimated by ROI-based measurements in the great abdominal vessels. A multivariate regression model was fit with the dependent variable “median bone marrow iodine uptake”. Standardized regression coefficients (β) were calculated to assess the impact of each covariate.Results678 consecutive DECT exams of 189 individuals (93 female, age 61.4 ± 16.0 years) were evaluated. AI-based segmentation provided volumetric data of 97.9% of the included vertebrae (n=11,286). The 95th percentile of bone marrow iodine uptake, as a surrogate for the upper margin of the physiological distribution, ranged between 4.7-6.4 mg/ml. vBMD (p <0.001, mean β=0.50) and portal vein iodine blood pool (p <0.001, mean β=0.43) mediated the strongest impact. Based thereon, adjusted reference values were calculated.ConclusionThe bone marrow iodine uptake demonstrates a distinct profile depending on vBMD, iodine blood pool, patient age, and sex. This study is the first to provide the adjusted reference values.

【 授权许可】

Unknown   
Copyright © 2023 Fervers, Fervers, Rinneburger, Weisthoff, Kottlors, Reimer, Zopfs, Celik, Maintz, Große-Hokamp and Persigehl