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Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT

Spondylolysis is underdiagnosed and often missed in non-musculoskeletal abdominal CT imaging. Our aim was to assess the inter-reader agreement and diagnostic performance of a novel “Darth Vader sign” for the detection of spondylolysis in routine axial images. We performed a retrospective search in t...

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Autores principales: Huber, Florian A., Schmidt, Cynthia S., Alkadhi, Hatem
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417292/
https://www.ncbi.nlm.nih.gov/pubmed/37568979
http://dx.doi.org/10.3390/diagnostics13152616
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author Huber, Florian A.
Schmidt, Cynthia S.
Alkadhi, Hatem
author_facet Huber, Florian A.
Schmidt, Cynthia S.
Alkadhi, Hatem
author_sort Huber, Florian A.
collection PubMed
description Spondylolysis is underdiagnosed and often missed in non-musculoskeletal abdominal CT imaging. Our aim was to assess the inter-reader agreement and diagnostic performance of a novel “Darth Vader sign” for the detection of spondylolysis in routine axial images. We performed a retrospective search in the institutional report archives through keyword strings for lumbar spondylolysis and spondylolisthesis. Abdominal CTs from 53 spondylolysis cases (41% female) and from controls (n = 6) without spine abnormalities were identified. A total of 139 single axial slices covering the lumbar spine (86 normal images, 40 with spondylolysis, 13 with degenerative spondylolisthesis without spondylolysis) were exported. Two radiology residents rated all images for the presence or absence of the “Darth Vader sign”. The diagnostic accuracy for both readers, as well as the inter-reader agreement, was calculated. The “Darth Vader sign” showed an inter-reader agreement of 0.77. Using the “Darth Vader sign”, spondylolysis was detected with a sensitivity and specificity of 65.0–88.2% and 96.2–99.0%, respectively. The “Darth Vader sign” shows excellent diagnostic performance at a substantial inter-reader agreement for the detection of spondylolysis. Using the “Darth Vader sign” in the CT reading routine may be an easy yet effective tool to improve the detection rate of spondylolysis in non-musculoskeletal cases and hence improve patient care.
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spelling pubmed-104172922023-08-12 Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT Huber, Florian A. Schmidt, Cynthia S. Alkadhi, Hatem Diagnostics (Basel) Article Spondylolysis is underdiagnosed and often missed in non-musculoskeletal abdominal CT imaging. Our aim was to assess the inter-reader agreement and diagnostic performance of a novel “Darth Vader sign” for the detection of spondylolysis in routine axial images. We performed a retrospective search in the institutional report archives through keyword strings for lumbar spondylolysis and spondylolisthesis. Abdominal CTs from 53 spondylolysis cases (41% female) and from controls (n = 6) without spine abnormalities were identified. A total of 139 single axial slices covering the lumbar spine (86 normal images, 40 with spondylolysis, 13 with degenerative spondylolisthesis without spondylolysis) were exported. Two radiology residents rated all images for the presence or absence of the “Darth Vader sign”. The diagnostic accuracy for both readers, as well as the inter-reader agreement, was calculated. The “Darth Vader sign” showed an inter-reader agreement of 0.77. Using the “Darth Vader sign”, spondylolysis was detected with a sensitivity and specificity of 65.0–88.2% and 96.2–99.0%, respectively. The “Darth Vader sign” shows excellent diagnostic performance at a substantial inter-reader agreement for the detection of spondylolysis. Using the “Darth Vader sign” in the CT reading routine may be an easy yet effective tool to improve the detection rate of spondylolysis in non-musculoskeletal cases and hence improve patient care. MDPI 2023-08-07 /pmc/articles/PMC10417292/ /pubmed/37568979 http://dx.doi.org/10.3390/diagnostics13152616 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Huber, Florian A.
Schmidt, Cynthia S.
Alkadhi, Hatem
Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT
title Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT
title_full Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT
title_fullStr Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT
title_full_unstemmed Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT
title_short Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT
title_sort diagnostic performance of the darth vader sign for the diagnosis of lumbar spondylolysis in routinely acquired abdominal ct
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10417292/
https://www.ncbi.nlm.nih.gov/pubmed/37568979
http://dx.doi.org/10.3390/diagnostics13152616
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