Diagnostic value of dual-energy CT virtual monochromatic imaging for supraspinatus tendon injuries: a comparison with standard CT and MRI

Abstract Objectives This study aimed to compare the diagnostic value of dual-energy computed tomography (DECT) virtual monochromatic imaging with that of standard computed tomography (SCT) in evaluating supraspinatus tendon injuries. Materials and methods This retrospective study involved patients who underwent a single-source DECT system, 3.0-T MRI, and shoulder arthroscopy within 14 days. Three radiologists independently and randomly evaluated SCT, mono+ 50 keV, mono+ 90 keV, and MRI images to detect supraspinatus tendon tears and recorded their diagnostic confidence. Regions of interest were delineated to measure the CT attenuation values of torn, degenerated, and normal tendon regions in SCT, mono+ 50 keV, and mono+ 90 keV images. Results A total of 100 patients with supraspinatus tendon injuries were included. Significant differences in detecting supraspinatus tendon injuries were observed between SCT and DECT ( p < 0.05) and between SCT and MRI ( p < 0.05), without showing differences in detecting supraspinatus tears between DECT and MRI. CT attenuation values of tears in SCT, mono+ 50 keV, and mono+ 90 keV images were significantly lower than those of degenerative and normal regions ( p < 0.001). Optimal CT attenuation values to differentiate between tears and degeneration on SCT, mono+ 50 Kev, and mono+ 90 Kev were 17.4, 28.0, and 14.2 with area under the curve (AUC) of 0.920, 0.978, and 0.938, respectively. Additionally, these values between degeneration and normal regions were 23.8 HU, 36.1 HU, and 19.6 HU with AUCs of 0.967, 0.970, and 0.946, respectively. Conclusion DECT demonstrated high diagnostic accuracy and reliability for qualitative and quantitative assessment of supraspinatus tendon injuries. Key Points Question Is DECT virtual monochromatic imaging capable of diagnosing supraspinatus tendon injuries when MRI is unavailable or contraindicated ? Findings DECT demonstrated high diagnostic accuracy and reliability for qualitative and quantitative assessment of supraspinatus tendon injuries . Clinical relevance DECT can effectively and reliably diagnose supraspinatus tendon tears using both qualitative and quantitative methods and holds promise as a supplementary tool for MRI . Graphical Abstract