Lumbar spine evaluation: accuracy on abdominal CT

To determine if the lumbar spine can be accurately evaluated on an abdominal CT.

The electronic medical records at our institution were searched to find all consecutive patients who had an abdominal CT within 12 months of a lumbar spine MRI obtained between 01 November 2010 and 31 October 2015. The abdominal CT studies were retrospectively reviewed in a blinded fashion for the presence of any significant lumbar spine abnormalities. The prospective lumbar spine MRI reports were used as the standard of reference.

5,031 patients had lumbar spine MRI studies at our institution during the study period of 01 November 2010 to 31 October 2015. 144 patients met the inclusion criteria of our study. No patients were excluded. 107 patients had 256 abnormal findings on the lumbar spine MRI studies. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of abdominal CT in lumbar spine evaluation on a per patient/per finding basis were 89.7/95.3%, 97.3/100%, 99.0/99.2%, 76.6/99.8% and 91.7/99.8%, respectively.

Despite several limitations (e.g. spinal cord assessment, bone marrow assessment and quantum mottle) compared with evaluation of the lumbar spine using MRI, evaluation of the lumbar spine on abdominal CT studies can be accurately performed with current state of the art CT scanners. Additional prospective studies are needed for a more definitive analysis. Advances in knowledge: With recent advances in CT technology, accurate evaluation of the lumbar spine on abdominal CT studies is feasible, potentially providing significant additional information to patients without additional imaging.