Clinical applications of a computed tomography color "marrow mapping" algorithm to increase conspicuity of nondisplaced trabecular fractures

Emerg Radiol. 2019 Feb;26(1):59-66. doi: 10.1007/s10140-018-1631-x. Epub 2018 Aug 9.


Purpose: To explore clinical applications of a novel conventional computed tomography (CT) color post-processing algorithm to increase conspicuity of nondisplaced trabecular fractures.

Materials and methods: The algorithm was created in Adobe Photoshop and Adobe Extendscript, utilizing DICOM images from conventional CT as source images. A total of six representative cases were selected and processed. No statistical analyses were performed.

Results: A total of six cases are demonstrated, five with MRI correlation demonstrating corresponding fractures and bone marrow edema, including a case of sacral insufficiency fracture, two cases of vertebral body fracture, two cases of nondisplaced hip fracture, and a knee bone marrow edema lesion (without MRI correlate). All cases were processed successfully without error.

Conclusions: A conventional CT color post-processing algorithm may be clinically useful in increasing conspicuity of nondisplaced fractures and bone marrow edema. A potential pitfall is the presence of subchondral or marrow sclerosis, which may mimic edema. Future prospective studies will be necessary to evaluate diagnostic performance.

Keywords: Bone contusion; Color post-processing; Computed tomography; Image manipulation; Occult fracture.

MeSH terms

  • Algorithms*
  • Bone Marrow / diagnostic imaging*
  • Color
  • Fractures, Bone / diagnostic imaging*
  • Humans
  • Magnetic Resonance Imaging
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Tomography, X-Ray Computed / methods