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DOI: 10.1148/radiol.2442060606
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Multidetector CT in Patients Suspected of Having Lumbar Disk Herniation: Comparison of Standard-Dose and Simulated Low-Dose Techniques1

Pascale Bohy, MD, Viviane de Maertelaer, PhD, Aymeric Roquigny, MD, Caroline Keyzer, MD, Denis Tack, MD, PhD, and Pierre Alain Gevenois, MD, PhD

1 From the Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium (P.B., P.A.G.); Department of Radiology, Réseau Hospitalier de Médecine Sociale, Baudour, Belgium (A.R., D.T.); Department of Radiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium (C.K.); and Statistical Unit, Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium (V.d.M.). Received April 5, 2006; revision requested June 5; revision received July 4; accepted August 2; final version accepted December 7. Address correspondence to P.A.G. (e-mail: Pierre.alain.gevenois{at}ulb.ac.be).


Figure 1A
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  		Figure 1a: Transverse multidetector CT images of L5-S1 disk herniation in 34-year-old man with right-sided sciatica and 24.5 kg/m2 BMI. Images obtained at (a) standard dose and at simulated (b) 65%, (c) 50%, (d) 35%, and (e) 20% of the standard dose. Note dorsal deviation of right nerve root (arrow) caused by herniated disk material (arrowhead).

 

Figure 1B
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  		Figure 1b: Transverse multidetector CT images of L5-S1 disk herniation in 34-year-old man with right-sided sciatica and 24.5 kg/m2 BMI. Images obtained at (a) standard dose and at simulated (b) 65%, (c) 50%, (d) 35%, and (e) 20% of the standard dose. Note dorsal deviation of right nerve root (arrow) caused by herniated disk material (arrowhead).

 

Figure 1C
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  		Figure 1c: Transverse multidetector CT images of L5-S1 disk herniation in 34-year-old man with right-sided sciatica and 24.5 kg/m2 BMI. Images obtained at (a) standard dose and at simulated (b) 65%, (c) 50%, (d) 35%, and (e) 20% of the standard dose. Note dorsal deviation of right nerve root (arrow) caused by herniated disk material (arrowhead).

 

Figure 1D
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  		Figure 1d: Transverse multidetector CT images of L5-S1 disk herniation in 34-year-old man with right-sided sciatica and 24.5 kg/m2 BMI. Images obtained at (a) standard dose and at simulated (b) 65%, (c) 50%, (d) 35%, and (e) 20% of the standard dose. Note dorsal deviation of right nerve root (arrow) caused by herniated disk material (arrowhead).

 

Figure 1E
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  		Figure 1e: Transverse multidetector CT images of L5-S1 disk herniation in 34-year-old man with right-sided sciatica and 24.5 kg/m2 BMI. Images obtained at (a) standard dose and at simulated (b) 65%, (c) 50%, (d) 35%, and (e) 20% of the standard dose. Note dorsal deviation of right nerve root (arrow) caused by herniated disk material (arrowhead).

 

Figure 2
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  		Figure 2: Graph shows agreements within readers for normal disk at the five doses: {blacktriangleup} = disk L3-4, bullet = disk L4-5, {blacksquare} = disk L5-S1. {kappa} values for agreement: reader 1 (black), reader 2 (white), and reader 3 (gray).

 

Figure 3
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  		Figure 3: Graph shows agreements within readers for bulging disk. See Figure 2 for definition of keys.

 

Figure 4
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  		Figure 4: Graph shows agreements within readers for herniated disk. See Figure 2 for definition of keys.

 

Figure 5
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  		Figure 5: Graph shows agreements between readers for normal disk at the five dose settings. {blacktriangleup} = disk L3-4, bullet = disk L4-5, {blacksquare} = disk L5-S1. {kappa} values for agreement: between readers 1 and 2 (black), between readers 2 and 3 (white), and between readers 1 and 3 (gray). Solid lines = first reading session, dashed lines = second reading session.

 

Figure 6
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  		Figure 6: Graph shows agreements between readers for bulging disk at the five doses. See Figure 5 for definition of keys.

 

Figure 7
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  		Figure 7: Graph shows agreements between readers for herniated disk at the five doses. See Figure 5 for definition of keys.

 




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