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Published on: October 14, 2022
Diagnostic performance of lumbar spine CT using deep learning denoising to evaluate disc herniation and spinal
Sungeun Park1, Ji Hee Kang2, Sung Gyu Moon1
1Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Objectives:
To evaluate the diagnostic performance of lumbar spine CT using deep learning denoising (DLD CT) for detecting disc herniation and spinal stenosis.
Materials And Methods:
This retrospective study included 47 patients (229 intervertebral discs from L1/2 to L5/S1; 18 men and 29 women; mean age, 69.1 ± 10.9 years) who underwent lumbar spine CT and MRI within 1 month. CT images were reconstructed using filtered back projection (FBP) and denoised using a deep learning algorithm (ClariCT.AI). Three radiologists independently evaluated standard CT and DLD CT at an 8-week interval for the presence of disc herniation, central canal stenosis, and neural foraminal stenosis. Subjective image quality and diagnostic confidence were also assessed using five-point Likert scales. Standard CT and DLD CT were compared using MRI as a reference standard.
Results:
DLD CT showed higher sensitivity (60% (70/117) vs. 44% (51/117); p < 0.001) and similar specificity (94% (534/570) vs. 94% (538/570); p = 0.465) for detecting disc herniation. Specificity for detecting spinal canal stenosis and neural foraminal stenosis was higher in DLD CT (90% (487/540) vs. 86% (466/540); p = 0.003, 94% (1202/1272) vs. 92% (1171/1272); p < 0.001), while sensitivity was comparable (81% (119/147) vs. 77% (113/147); p = 0.233, 83% (85/102) vs. 81% (83/102); p = 0.636). Image quality and diagnostic confidence were superior for DLD CT (all comparisons, p < 0.05).
Conclusion:
Compared to standard CT, DLD CT can improve diagnostic performance in detecting disc herniation and spinal stenosis with superior image quality and diagnostic confidence.
Key Points:
Question The accurate diagnosis of disc herniation and spinal stenosis is limited on lumbar spine CT because of the low soft-tissue contrast. Findings Lumbar spine CT using deep learning denoising (DLD CT) demonstrated superior diagnostic performance in detecting disc herniation and spinal stenosis compared to standard CT. Clinical relevance DLD CT can be used as a simple and cost-effective screening test.
