Bone-removal algorithm opens a window into trauma-induced brain bleeds

Researchers have demonstrated an automated bone-removal algorithm that works with dual-energy CT to let physicians see, unobstructed by the skull, what’s going on in the brains of patients with intracranial hemorrhage following head trauma.

The preliminary study was conducted at the University of Toyama in Japan and published online Sept. 20 in Emergency Radiology.

Norihito Naruto, MD, and colleagues reviewed the scans of 16 patients with acute intracranial hemorrhage who were imaged with a dual-source, dual-energy CT scanner within one day after the incident causing the trauma.

The team compared the detectability of acute hemorrhagic lesions as visualized by simulated standard CT vs. CT with their bone-removal application.

The researchers found their application yielded significantly superior images, showing 100 percent of confirmed epidural/subdural hemorrhages (28 of 28).

By comparison, the simulated standard scan captured only 17 of these 28 hemorrhages (61 percent).

Further, when it came to detecting 17 contusional hemorrhages, the bone-removal CT beat the standard CT to the tune of 100 percent vs. 65 percent.

The imaging also turned up seven subarachnoid hemorrhages.

Naruto and colleagues conclude that their approach to bone-removal brain CT “could improve the detection of small intracranial hemorrhages, particularly those adjacent to bone, by removing bone that can interfere with the visualization of small acute hemorrhage.”

In emergencies involving head trauma, they add, “bone-removal CT can be used as support imaging in combination with simulated standard CT and bone scale CT, although bone-removal CT cannot replace a simulated standard CT.”