Authors
Derya Karabulut, Aykut Alkan
Published in
Academic radiology. Oct 12, 2026. Epub Oct 12, 2026.
Abstract
The aim of this study is to evaluate the additional diagnostic value of CT Bone Reading software in detecting rib metastases on thoracic computed tomography in patients with breast cancer and to examine its effectiveness on lesion detection, evaluation time, and inter-reader agreement.
This retrospective study included 110 patients with breast cancer and bone metastases who underwent both thoracic computed tomography (CT) and positron emission tomography-CT scans between January 2022 and January 2026. For lesion-level assessment, suspected rib lesions were also evaluated using available longitudinal follow-up imaging. Two radiologists independently evaluated conventional CT and CT Bone Reading images in separate reading sessions at least 2 weeks apart. Inter-reader agreement was assessed using the intraclass correlation coefficient (ICC) and Cohen's κ statistic.
In lesion-based analysis with conventional CT, Reader 1 detected 510 lesions (81.6%) and Reader 2 detected 577 lesions (92.3%), while CT Bone Reading allowed for the detection of an additional 115 (22.5%) and 48 (8.3%) lesions for Readers 1 and 2, respectively. The additionally detected lesions demonstrated a non-uniform distribution, with a marked predominance in the mid-rib region (levels 5th-8th). CT Bone Reading-assisted evaluation enabled the detection of significantly smaller lesions compared to routine CT for both readers (Reader 1: 8.0 mm vs 5.0 mm; Reader 2: 7.0 mm vs 5.0 mm; P < 0.001 for both). Evaluation time was significantly decreased from 129.22 ± 27.22 s to 64.94 ± 17.16 s for Reader 1 and from 122.99 ± 26.04 s to 64.44 ± 18.71 s for Reader 2 (P < 0.001 for both). Inter-reader agreement was excellent for measurements obtained by CT Bone Reading-derived evaluation (ICC ≥0.965; κ ≥0.947).
CT Bone Reading software increases the detection rates of rib lesions, reduces interpretation times, and demonstrates excellent inter-reader reproducibility compared to conventional CT assessment, with less experienced readers achieving the highest incremental throughput. By providing a comprehensive and continuous view of the ribs, this technique has the potential to improve diagnostic performance without additional radiation exposure, particularly in anatomically complex regions such as the mid ribs. Ultimately, this approach can enhance workflow efficiency during routine clinical practices.
PMID:
42864177
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.
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