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 van der Kolk et al. investigated whether the image quality of a specific deep learning-based [[synthetic CT]] (sCT) of the [[cervical spine]] is non-inferior to conventional CT. van der Kolk et al. investigated whether the image quality of a specific deep learning-based [[synthetic CT]] (sCT) of the [[cervical spine]] is non-inferior to conventional CT.
  
-Paired [[MRI]] and [[CT]] [[data]] were collected from 25 consecutive participants (≥ 50 years) with [[cervical radiculopathy]]. The MRI exam included a T1-weighted multiple gradient echo sequence for sCT reconstruction. For qualitative image assessment, four structures at two vertebral levels were evaluated on sCT and compared with CT by three assessors using a four-point scale (range 1-4). The noninferiority margin was set at 0.5 points on this scale. Additionally, acceptable image quality was defined as a score of 3-4 in ≥ 80% of the scans. The quantitative assessment included geometrical analysis and voxelwise comparisons.+Paired [[MRI]] and [[CT]] [[data]] were collected from 25 consecutive participants (≥ 50 years) with [[cervical radiculopathy]]. The MRI exam included a [[T1]]-weighted multiple [[gradient echo]] sequence for sCT reconstruction. For qualitative image assessment, four structures at two vertebral levels were evaluated on sCT and compared with CT by three assessors using a four-point scale (range 1-4). The noninferiority margin was set at 0.5 points on this scale. Additionally, acceptable image quality was defined as a score of 3-4 in ≥ 80% of the scans. The quantitative assessment included geometrical analysis and voxelwise comparisons.
  
 Qualitative image assessment showed that sCT was non-inferior to CT for overall bone image quality, artifacts, imaging of intervertebral joints and neural foramina at levels C3-C4 and C6-C7, and cortical delineation at C6-C7. Noninferiority was weak to absent for cortical delineation at levels C3-C4 and trabecular bone at both levels. Acceptable image quality was achieved for all structures in sCT and CT, except for trabecular bone in sCT and level C6-C7 in CT. Geometrical analysis of the sCT showed good to excellent agreement with CT. Voxelwise comparisons showed a mean absolute error of 80.05 (±6.12) HU, dice similarity coefficient (cortical bone) of 0.84 (±0.04) and structural similarity index of 0.86 (±0.02). Qualitative image assessment showed that sCT was non-inferior to CT for overall bone image quality, artifacts, imaging of intervertebral joints and neural foramina at levels C3-C4 and C6-C7, and cortical delineation at C6-C7. Noninferiority was weak to absent for cortical delineation at levels C3-C4 and trabecular bone at both levels. Acceptable image quality was achieved for all structures in sCT and CT, except for trabecular bone in sCT and level C6-C7 in CT. Geometrical analysis of the sCT showed good to excellent agreement with CT. Voxelwise comparisons showed a mean absolute error of 80.05 (±6.12) HU, dice similarity coefficient (cortical bone) of 0.84 (±0.04) and structural similarity index of 0.86 (±0.02).
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