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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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/15/2616 |
| _version_ | 1797586901009432576 |
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| author | Florian A. Huber Cynthia S. Schmidt Hatem Alkadhi |
| author_facet | Florian A. Huber Cynthia S. Schmidt Hatem Alkadhi |
| author_sort | Florian A. Huber |
| collection | DOAJ |
| 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 (<i>n</i> = 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. |
| first_indexed | 2024-03-11T00:29:44Z |
| format | Article |
| id | doaj.art-bf51481010024cfd8b2d8473c0c6d311 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T00:29:44Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-bf51481010024cfd8b2d8473c0c6d3112023-11-18T22:47:54ZengMDPI AGDiagnostics2075-44182023-08-011315261610.3390/diagnostics13152616Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CTFlorian A. Huber0Cynthia S. Schmidt1Hatem Alkadhi2Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, SwitzerlandSpondylolysis 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 (<i>n</i> = 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.https://www.mdpi.com/2075-4418/13/15/2616computed tomographyspondylolisthesisspondylolysislumbar spine |
| spellingShingle | Florian A. Huber Cynthia S. Schmidt Hatem Alkadhi Diagnostic Performance of the Darth Vader Sign for the Diagnosis of Lumbar Spondylolysis in Routinely Acquired Abdominal CT Diagnostics computed tomography spondylolisthesis spondylolysis lumbar spine |
| 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 | computed tomography spondylolisthesis spondylolysis lumbar spine |
| url | https://www.mdpi.com/2075-4418/13/15/2616 |
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