European Journal of Trauma and Emergency Surgery (2020) 46:187–195

https://doi.org/10.1007/s00068-018-1021-9

ORIGINAL ARTICLE

Comparison of thick- and thin-slice images in thoracoabdominal

trauma CT: a retrospective analysis
Leon Guchlerner1 · Julian Lukas Wichmann1 · Patricia Tischendorf1 · Moritz Albrecht1 · Thomas Josef Vogl1 ·
Sebastian Wutzler2 · Hanns Ackermann3 · Katrin Eichler1 · Claudia Frellesen1

Received: 1 May 2018 / Accepted: 25 September 2018 / Published online: 28 September 2018
© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Abstract
Purpose To compare thick (5 mm) and thin slice images (1.5 mm) of lung, soft tissue, and bone window in thoracoabdominal
trauma computed tomography.
Materials and methods 167 Patients that underwent thoracoabdominal trauma CT between November 2014 and December
2015 were included in the study. CT data were reconstructed in a transverse direction with 5 mm and 1.5 mm slice images
of lung, soft tissue, and bone window. Two blinded raters (radiologists) evaluated the collected data by detecting predefined
injuries in different organ areas. Reconstruction and evaluation times as well as detected injuries were noted and compared.
Results Reconstruction and evaluation times were significantly higher with 1.5 mm thin-slice images, and the effect strength
according to Rosenthal displayed a strong effect of 0.61 (< 0.1 small effect, 0.3 middle effect, and > 0.5 strong effect). Average
evaluation time differences were 62.7 s (33.9 s–91.5 s) in bone window between 1.5 mm and 3 mm for rater 1 (p < 0.001) and
71.4 s (43.1 s–99.7 s) for rater 2 (p < 0.001). Average time differences between 1.5 mm and 5 mm were 68,7 s (43.9 s–93.5 s)
for rater 1 and 75.3 s (44.7 s–105.9 s) for rater 2 in lung window (p < 0.001) and 66.6 s (28.8 s–104.4 s) for rater 1 and 114 s
(74.4 s–153.6 s) for rater 2 in soft-tissue window (p < 0.001). There was no significant difference regarding soft-tissue and
lung injuries, except non-significant improvement in the detection of bone fractures.
Conclusion Thin-slice images do not bring any significant benefit in thoracoabdominal trauma CT of soft-tissue and lung
injuries, but they can be helpful for the diagnosis of bone fractures and incidental findings.

Keywords Trauma · CT diagnostic · Soft tissue · Bone · Slice thickness

Introduction to reveal concealed internal, potentially life-threatening

Accident-related trauma is one of the most common causes
of death for young adults in Germany [1, 2]. A detailed and
quick diagnostic measure is, therefore, of high importance
* Leon Guchlerner
leon.guchlerner@gmail.com
1 The early usage of CT-supported imaging demonstrably
Department of Diagnostic and Interventional Radiology,
Institut fuer Diagnostische und Interventionelle
Radiologie, Clinic of the Goethe University, Haus 23C UG,
Theodor‑Stern‑Kai 7, 60590 Frankfurt am Main, Germany
2
Department of Trauma, Hand and Reconstructive Surgery,
Clinic of the Goethe University, Theodor‑Stern‑Kai 7,
60590 Frankfurt, Germany
3
Department of Biostatistics and Mathematical Modelling,
Clinic of the Goethe University, Theodor‑Stern‑Kai 7,
60590 Frankfurt, Germany
trauma. Radiologic diagnostics including conventional
X-ray, sonography, and CT is beneficial in this context [2–4].
Whole-body computed tomography (WBCT) is gaining
importance in primary diagnosis of inner organ injuries by
quick detection [5, 6]. It allows a highly sensitive evaluation
method to assess the aftermath of life-threatening accidents
[7–9]. Meanwhile, it has become a standard procedure for
hemodynamically stable patients [10].
increases the survival time of polytraumatized patients [11].
For the evaluation of trauma sequelae, there are different
slice thicknesses available for different organ areas [12–14].
They differ in amount of picture data and evaluation time,
which impacts on clinical practice and handling of trauma
patients [15]. A crucial factor in dealing with polytrauma-
tized patients is to find hidden life-threatening injuries (e.g.,
internal bleeding of unknown origin) as fast as possible and

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to initiate immediate action. Longer evaluation times may
be obstructive in this emergency situation. Thin slices often
find usage in extended exploration of small cysts, tumor
classification, and for seeking metastases [16–19], whereas
thick slices are normally utilized for the swift detection
of trauma and other pathologies [17]. The question arose
whether thin- or thick-sliced computed tomography gives
better results in terms of clinical applicability in emergency
situations and accuracy of the final diagnosis [14, 17, 18].
In our study, we retrospectively evaluated if 1.5 mm axial
images provide diagnostic advantage over 5 mm images in
the detection of thoracoabdominal injury regarding differ-
ent window settings (lung, soft tissue, and bone). In addi-
tion, incidental findings and small osseous incidents were
examined.
and lung window and 3 mm for bone window as in-house
standard. In addition, thin-slice axial images with 1.5 mm
were deployed as experimental for all window settings.
Table 1 gives an overview of reconstruction parameters.
All planes and slice thicknesses were calculated out of raw
image data from a scan in a mixed phase with a collimation
of 0.6 mm. 5 mm slices were calculated standardly out of
raw image data; 1.5 mm slices were reconstructed addition-
ally by medical-technical assistants.
The reconstruction time of all picture data was manually
measured with a stopwatch and noted for each patient in
standard and experimental slice thickness for all window
settings.
Objective image analysis

Materials and methods All quantitative measurements were performed on a com-

Patient population
The study was approved by the ethic committee of our hos-
pital and the data were retrospectively acquired. 167 patients
(45 F/122 M) with an average age of 49.9 (28.8–71) years,
which had undergone clinically indicated thoracoabdominal
trauma CT between November 2014 and December 2015
were included in the analysis. Patients younger than 18 years
or without complete CT data were excluded.
CT protocol and reconstruction parameters
CT scans were implemented on a 64-slice sliding gantry
CT (Somatom Definition AS 64, Siemens) as monophasic
contrast-enhanced thoracoabdominal CT [20] with arms ele-
vated above the head to avoid artifacts and additional radia-
tion exposure. 100 ml of contrast material (Xenetix 350,
Guerbet, Sulzbach, Germany) followed by a 50 ml NaCl
chaser bolus were injected at a flow rate of 2 ml/s. The scan
delay was 80 s after the start of injection. The length of the
scan extended from the seventh cervical spine to the sym-
physis. Reconstruction kernels were chosen as follows: B60f
for lung, B30f for soft tissue, and B70f for bone window.
5 mm slice axial images were reconstructed for soft tissue
mercially available PACS workstation (Centricity 4.2, GE
Healthcare, Dornstadt, Germany) using a standard cross-
sectional imaging reading monitor (RadiForce RX240, Eizo,
Ishikawa, Japan) by placing regions of interest (ROI). Back-
ground noise (BN) was defined as the standard deviation of
attenuation measured in the air outside the thorax on the
level of the carina (BNchest) and outside the abdomen on
the level of the celiac trunk (BNabd) with sufficient distance
to the body to avoid distorted values due to blankets or bear-
ing devices close to the patient. Attenuation was measured
in the following anatomic structures: in the thoracic aorta
(ROIaortaTH), the abdominal aorta (ROIaortaABD), in the
liver parenchyma (ROIliver) and the portal vein (ROIpvein),
in the spleen (ROIspleen), in the kidney including cortex
and parenchyma (ROIkidney), and in the pancreas (ROIpan-
creas). The signal-to-noise ratio (SNR), which measures the
technical quality of a signal in the chest, was calculated in
the thoracic aorta (SNRaortaTH = ROIaortaTH/BNchest).
The SNR in the abdomen was calculated, e.g., in the liver
(SNRliver = ROIliver/BNabd); SNR for other organs were
calculated accordingly [21].
The scan lengths (SL) between experimental and standard
slice thicknesses were calculated by the quotient of the dose-
length product (DLP) and the computed tomography dose
index (CTDI) and were later compared (SL = DLP/CTDI).

Table 1  Reconstruction Window Standard reconstruction parameters Thin-slice reconstruction parameters

parameters
B60f (lung) Transverse: 5 mm/5 mm Transverse: 1.5 mm/0.7 mm
B30f (soft tissue) Transverse 5 mm/5 mm Transverse 1.5 mm/0.7 mm
Coronal: 3 mm/2 mm Coronal: 3 mm/2 mm
B70f (spine) Transverse: 3 mm/1 mm Transverse: 1.5 mm/0.7 mm
Coronal: 2 mm/2 mm Coronal: 2 mm/2 mm
Sagittal: 2 mm/2 mm Sagittal: 2 mm/2 mm

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Comparison of thick- and thin-slice images in thoracoabdominal trauma CT: a retrospective… 189

Subjective image analysis
The subjective analysis was performed by two independent
raters (radiologists) with 5 and 3 years of experience, respec-
tively. The raters evaluated each image stack from both,
standard and experimental slice thickness, in a randomized
order, and had no contact with each other during the assess-
ment of picture data. Between the first and the second read-
ing of matching CT images in 5 mm and 1.5 mm both raters
underwent a 30- to 60-day interval to minimize recognition
effects. The two raters were blinded against personal patient
data and the diagnosis of the first CT scan before recon-
struction, so that neither rater knew trauma consequences of
probands before the study began. Blinding against the slice
thickness of the rated picture data was not possible due to a
much higher image volume in the thinner layers. Evaluation
time was manually recorded and the comparison results of
predetermined organ systems were analyzed. The rating pro-
tocol (Table 2) with predefined pathologies was developed,
so that both raters could assess the same organ areas for a
comparable evaluation outcome.
The raters reviewed CT data on axial images in lung, soft
tissue, and bone window, and identified organ traumata of
different body regions (Table 2). The dichotomous decision
whether trauma consequences are present in named areas
was noted. They could adjust brightness settings to their
preferred range. The radiological report was treated as the
gold standard regarding all the findings.
the beginning of the evaluation process of each set of patient
picture data, in different organ areas and slice thicknesses,
the rater gave a starting signal to the timekeeper who started
the stopwatch. The watch was stopped as soon as the rater
signaled his completion of the evaluation (Fig. 1).
Statistical analysis
Statistical analysis was carried out with the aid of BiAS soft-
ware (BiAS 11.02 for Windows, Epsilon Verlag, Frankfurt,
Germany). Interrater analysis of trauma incidents was car-
ried out using Cohen’s weighted kappa to show agreement
between the two raters during examination (k > 0.81 excel-
lent agreement, k = 0.61–0.8 good agreement, k = 0.41–0.6
moderate agreement, k = 0.21–0.4 fair agreement, and
k < 0.20 poor agreement). McNemar’s test was additionally
used for interrater event verification with Zimmermann’s
effect strength ω2 (ω2 = 0.01 low, ω2 = 0.1 moderate, and
ω2 = 0.25 great effect strength) and Chinn’s f/Cohen’s d
effect strength (Chinn/Cohen: d = 0.2 low, d = 0.5 moder-
ate, and d = 0.8 great effect).
Wilcoxon matched-pairs test with Hodges–Lehmann
Assessor calculated the average evaluation time difference
between 1.5 mm CT data and 5 mm, respectively, 3 mm (in
bone window) for the analysis of interrater time variations. p
value under 0.05 was considered as a statistically significant
difference in all the tests.

Time analysis Results

The assessment time of each rater was manually measured Objective image data quality (compared using SNR) was
and noted throughout the evaluation of lung, soft tissue, and significantly lower in 1.5 mm images compared to stand-
bone window in thick and thin slices of every proband. At ard 5 mm images (p < 0.001). The average SNR was 8.64

Table 2  Rating protocol Lung window Soft-tissue window Bone window

Pneumothorax Mediastinal bleeding Rib fracture

Lung parenchyma injuries Pericardial effusion Clavicular fracture
Free air Liver Spine fracture
Soft-tissue emphysema Gallbladder Sternal fracture
Incidental findings Pleural effusion Pelvic fracture
Pancreas Sternoclavicular joint
Spleen Hip joint
Stomach Incidental findings
Small intestine
Colon
Bleeding of unknown origin
Free liquid
Aortic trauma
Soft-tissue hematoma
Incidental findings

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190 L. Guchlerner et al.

(8.61–8.67) in 1.5 mm and 12.73 (12.68–12.78) in 5 mm

Fig. 1  Example images of a 23-year-old male patient who received a
WBCT after being involved in a bike accident. Experimental 1.5 mm
(a) and standard 5 mm (b) image data show a small liver laceration
(arrows) which were identified by both raters in both evaluated slice
thicknesses. The images (a) and (b) provide comparable diagnostic
accuracy
images. In addition, there was no significant difference in
the scan lengths (p > 0.05).
The average reconstruction time of 1.5 mm images was
significantly longer than the one of 5 mm images with 33.1 s
(27.7 s–38.5 s) for 1.5 mm images and 10.3 s (9.2 s–11.4 s)
for 5 mm images (p < 0.001). The average number of images
per data set was 981.9 (878.1–1085.7) for 1.5 mm images
and 137.8 (123.7–151.9) for 5 mm images (p < 0.001).
Regarding the 3 mm images, the reconstruction time was
17.1 s (15.3 s–18.9 s) with an average number of images per
data set of 228.6 (204.3–252.9) (p < 0.001) (Table 3).
Analysis showed that both raters took significantly
more time evaluating 1.5 mm images than 5 mm images
(p < 0.001). The average evaluation time for 1.5 mm
images was 214.2 s (174.9 s–253.5 s) for rater 1 and 240 s
(196.1 s–283.9 s) for rater 2 (p < 0.001), while it was
148.2 s (115.4 s–181 s) for 5 mm (respectively 3 mm in
bone window) for rater 1 and 153 s (118.2 s–187.8 s) for
rater 2 (p < 0.001). Rater 1 took an average of 656.1 s
(655.9 s–656.3 s) of per patient in experimental 1.5 mm
images and an average of 450 s (449.8 s–450.2 s) in stand-
ard 5 mm (and 3 mm) images (p < 0.001). Rater 2 took an
average of 723.1 s (722.9 s–723.3 s) of evaluation time per
patient in 1.5 mm and an average of 459.8 s (459.6 s–460 s)
in 5 mm (and 3 mm) images (p < 0.001).
In all evaluations of the rating protocol, rater 1 discovered
a total of 164 pathologies in the observed areas (Table 2) in
5 mm for lung and soft tissue and in 3 mm for bone trauma,

Table 3  Image number and 1.5 mm 5 mm 3 mm

duration of different slice
thickness reconstructions Image number 980.9 (878.1–1085.7) 137.8 (123.7–151.9) 288.6 (204.3–252.9)
Reconstruction time 33.1 s (27.7 s–38.5 s) 10.3 s (9.2 s–11.4 s) 17.1 s (15.3 s–18.9 s)

Table 4  Number of pathologies found in the study population

Thorax Gold standard Soft tissue Gold standard Bone Gold standard

Pneumothorax 21 Liver 5 Rib fracture 22

Lung parenchyma injuries 19 Gallbladder 0 Clavicular fracture 6
Free air 5 Pancreas 0 Spine fracture 11
Soft-tissue emphysema 22 Spleen 1 Sternal fracture 3
Incidental findings 1 Stomach 0 Pelvic fracture 6
Pleural effusion 6 Small intestine 0 Sternoclavicular joint 0
Mediastinal bleeding 1 Colon 0 Hip joint 2
Pericardial effusion 0 Kidney 2 Incidental findings 0
Free liquid 10
Aortic trauma 2
Soft-tissue hematoma 12
Incidental findings 8
Total (165) 74 41 50

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Comparison of thick- and thin-slice images in thoracoabdominal trauma CT: a retrospective… 191

while rater 2 discovered a total of 161 pathologies. Table 4

shows the total number of pathologies found in the study
population. McNemar´s test for intra-observer distinction
revealed no significant variance (p > 0.05). Rater 1 and 2
had a 98.2% accordance in the interobserver comparison
detecting trauma sequelae. Investigation results differed only
in three incidental findings of lesions in kidney and liver
of different patients. These findings were confirmed by the
gold standard.
Rater 1 had a sensitivity of 99.4% and a specificity of
99.1%, while rater 2 had a sensitivity of 97.5% and a speci-
ficity of 98.5%. These high results can be explained by the
predefined evaluation areas in our rating protocol (Table 2).
In layer comparison (1.5 mm versus 5 mm/3 mm),
Cohen’s Kappa calculated average results of 0.98 (0.96–1) in
lung (p < 0.001), 0.83 (0.66–1) in soft tissue (p < 0.001), and
0.89 (0.78–1) in bone (p < 0.001) analysis for rater 1. Rater 2
had similar average results: 0.93 (0.86–1) in lung (p < 0.001),
0.85 (0.69–1) in soft tissue (p < 0.001), and 0.9 (0.8–1) in
bone analysis (p < 0.001). The null hypothesis, that there is
no difference between standard and experimental evaluation
method, can be adopted. The additional appraisal in sagit-
tal planes during bone window analysis showed two hidden
fractures of transverse processes of vertebrae.
Fig. 2  Example images of a 24-year-old male patient who underwent
a WBCT after a fall from about 4 m. The arrows indicate a small ven-
tral pneumothorax which was equally discovered by both raters in
Discussion experimental 1.5 mm (a) and standard 5 mm (b) slice thicknesses

Whole-body computed tomography (WBCT) has a well-

established role in trauma diagnostic due to high accuracy
and fast detection time [5, 7, 8, 22]. Higher image quality
and thinner CT layers demand a longer reconstruction time
and higher capacities of data storage space [23]. Thin-sliced
computed image material is often used for the identification
of fractures and expanding lesions [14, 16, 17, 19]. To our
knowledge, the benefit of thin-sliced CT data on thoracoab-
dominal organs in trauma diagnostics, however, has not been
demonstrated or observed yet. The results of the comparison
of 5 mm and 1.5 mm slice axial images in our study show no
additional benefit from the utilization of thinner slice images
in thoracoabdominal trauma CT (Figs. 2, 3).
In 2010, Soo et al. investigated the advantages and dis-
advantages of 2.5, 5, 7.5, and 10 mm reconstructions of CT
images on the detection of liver lesions. Their study reported
significantly improved sensitivity in 2.5 and 5 mm (92% in
2.5 mm and 98% in 5 mm) as compared with 7.5 mm (78%
sensitivity) and 10 mm (54% sensitivity). In addition, they
noticed an impaired diagnostic accuracy in 2.5 mm com-
puted slices compared to 5 mm (92% sensitivity in 2.5 mm
versus 98% in 5 mm) due to lower SNR. The study con-
cludes that it is not just the thinnest CT slices which bring
the highest diagnostic accuracy, but the balance of slice
thickness and background noise [24].
Similar results were reported in Abdelmoumene et al.’s
study in 2005, where 5 mm reconstructed slice thick-
ness with elementary collimation of 5 and 3.75 mm was
compared with 2.5 mm reconstructed slice thickness with
2.5 mm elementary collimation in the diagnosis of liver
metastases. The results showed that 5 mm slice thickness
proved to be more effective in the detection of small liver
metastases, again because of higher noise in 2.5 mm slices
[25].
Both studies explored different slice thicknesses on CT
for staging purposes, which differs from our investigation in
trauma diagnostic. However, each of them still manages to
show, just like our results, that thinner slices do not always
imply higher likelihood of finding hidden lesions.
In our study, however, we managed to detect nine cases,
in which fractures were found in 1.5 mm transverse bone
window evaluation and following sagittal appraisal, that
were not identified in their 3 mm correlate [13, 14]. Those
nine fractures consisted of three rib fractures and six frac-
tures of transverse process on cervical, thoracic, and lum-
bar spine on different patients. These rib and transverse
process fractures had no impact on the first-line treatment
that the patients received, because they were not life rel-
evant at that moment, but they still could give an indirect

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Fig. 3  Example images of a 38-year-old male patient who received
a WBCT after he had fallen down the stairs. In both, experimental
1.5 mm (a) and 5 mm (b) slice thicknesses, the raters identified a ven-
tral discreet lung contusion (arrows)
indication for underlying hidden organ trauma [26]. Thus,
the usage of 1.5 mm can be helpful to detect hidden frac-
tures with potential clinical relevance. The identification
of every rib and spine injury could improve the patients’
rehabilitation time by facilitating a proper treatment [27].
When it comes to unstable hidden spine fractures, the
additional information theoretically provided about them,
could allow a better first-line treatment, and, consequently,
improve the patients´ outcome directly [28–30]. However,
during our appraisal, there were no further hidden frac-
tures of vertebra bodies detected in 1.5 mm, which had
not already been identified in correspondent 3 mm slices.
A supplementary inspection in sagittal layers showed a
clearer view on the rib and two hidden spine fractures
in the present cases. Whether sagittal CT layers could
find hidden fractures more effectively, should be further
investigated in additional studies. Besides, three inciden-
tal findings, which were not clinically relevant during the
emergency of polytrauma, were found in 1.5 mm but not
in 5 mm soft-tissue evaluation. These incidental findings,
however, deserve proper investigation after the sufficient
treatment of the trauma sequelae. The three discovered
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L. Guchlerner et al.
Fig. 4  Example images of a 47-year-old male patient who underwent
a WBCT after being involved in a car accident. The arrows indicate
a small ventral pneumothorax and the stars are located next to a rib
fracture. The raters concordantly identified both trauma sequelae in
experimental 1.5 mm (a) and standard 5 mm (b) slice thicknesses
findings were: one kidney cyst of small diameter, one liver
hemangioma, and a small lipoma (Figs. 4, 5).
Objective image analysis showed that thinner CT slices
impair picture quality and reduce evaluation accuracy
through higher background noise [31]. Moreover, thinner
slices of 1.5 mm cause a higher picture count, which results
in a higher processing length during conversion from raw
data to reconstructed CT data. They also demand a higher
evaluation time. These disadvantages lead to an extended
diagnostic duration for trauma patients during emergency
situations, which could affect a patient´s prognosis and
health negatively [32].
Our study has limitations that need to be acknowledged
beyond the retrospective design. Raters could not be blinded
against the layer thickness which they were evaluating,
because thinner slices result in much greater picture count.
The raters were, therefore, aware which CT slices they were
analyzing and whether the pictures had been reconstructed
in a standard or experimental way. Some patients showed
a low share of trauma consequences. This circumstance is
explicable, since indication for polytrauma diagnostic is
Comparison of thick- and thin-slice images in thoracoabdominal trauma CT: a retrospective…
Fig. 5  Example images of a 48-year-old male patient who received a
WBCT after a scooter accident. Experimental 1.5 mm (a) and stand-
ard 3 mm (b) image data enabled both raters to identify the shown rib
fracture (arrows)
enclosing and justified through injury mechanism. The study
was carried out with a 64-slice CT scanner. Image quality
and evaluation time differ on devices with other (especially
lower) technical specifications. This can affect the generaliz-
ability of our study [13, 33].
The prevalence effect may also influence the transferabil-
ity of our results: This study took place in one of Frankfurt´s
largest trauma centers with a high prevalence of patients
with severe polytrauma. Therefore, many patients had mul-
tiple major injuries, which could increase evaluation suc-
cess. Other centers with lower numbers of polytraumatized
patients might encounter a decreased amount of trauma con-
sequences and, thus, a shorter appraisal time and a smaller
diagnostic accuracy. Gur et al., however, showed in their
study that the prevalence effect in laboratory conditions is
negligibly small [13, 34].
We defined a rating protocol to standardize the evalua-
tion of regions after trauma through the two raters in terms
of assessment time and accuracy. In addition, this rating
protocol had the objective of minimizing the satisfaction
193
Fig. 6  Example images of a 54-year-old male patient who under-
went a WBCT after getting trapped at a building site. In experimental
1.5 mm (a) and standard 3 mm (b) image data, the stars are located
next to a quickly recognizable fracture of a rib body, while the arrows
indicate a smaller rib head fracture. The raters equally identified both
shown fractures in 1.5 mm (a) and 3 mm (b) slice thicknesses despite
the risk of overlooking the small fracture (arrows) owing to the satis-
faction of search phenomenon
of search phenomenon, in which an observer might miss
a radiologic diagnosis due to the interference of another
finding. Despite this precaution, the satisfaction of search
phenomenon might have influenced the detection of small,
but relevant bone fractures, which could finally be shown
in 1.5 mm experimental layers and in sagittal view (Fig. 6
shows simultaneously occurring small rib fractures in
which the satisfaction of search phenomenon may arise)
[13, 35, 36].
In conclusion, there is no diagnostic advantage of
1.5 mm over 5 mm in thoracoabdominal trauma CT
regarding lung and soft-tissue pathologies. The evalua-
tion of bone pathologies and small incidental findings,
however, benefits from thinner computed images through
higher diagnostic accuracy (Fig. 7).
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194
Fig. 7  Example images of a 67-year-old male patient who received
a WBCT after being involved in a serious car accident. The arrows
show a ventral vertebra body fracture which was concordantly discov-
ered by both raters in experimental 1.5 mm (a) and 3 mm (b) slice
thicknesses
Funding No funding was received for this study.
Compliance with ethical standards
Conflict of interest Julian L. Wichmann received speakers’ fees from
GE Healthcare and Siemens Healthcare. Moritz H. Albrecht received
speakers’ fees from Siemens Healthcare. The other authors declare that
they have no conflict of interest.
Research involving human participants and/or animals For this type
of study, formal consent is not required. This article does not contain
any studies with human participants or animals performed by any of
the authors.
Informed consent Informed consent was obtained from all individual
participants included in the study.
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