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Gallstones Detection on Dual-Energy Computerized Tomography-Is It Ready for Real-World Use? A Retrospective Observational Study
Journal article   Open access   Peer reviewed

Gallstones Detection on Dual-Energy Computerized Tomography-Is It Ready for Real-World Use? A Retrospective Observational Study

Shambo Guha Roy, Vaibhav Gulati, Laura Machado Pichardo, Salama Chaker, Marion Brody, Scott Rotenberg, Reza Hayeri, Jeffrey Poot and Oleg Teytelboym
Journal of computer assisted tomography, v 48(1), pp 35-41
01 Jan 2024
DOI: https://doi.org/10.1097/RCT.0000000000001535
PMID: 37531641
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444345View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open
url
https://doi.org/10.1097/RCT.0000000000001535View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Radiology, Nuclear Medicine & Medical Imaging Science & Technology
AimsThe aims of the study are to evaluate the performance of dual-energy computed tomography (DECT) imaging in the detection of noncalcified gallstones (GSs) and to assess its performance relative to transabdominal ultrasound (US) in identifying cholelithiasis.MethodThis study is a retrospective review of radiology records and images to find all patients who had both US and DECT scans within a 6-month period and were found to have GSs. Patients who did not have GSs on US served as the control group. The CT scans were reviewed by 4 radiologists who did not have access to the US results when assessing the presence or absence of GSs on the DECT scans. In case of any discrepancies among the radiologists, the majority opinion was considered. If there was a split opinion, a fifth reviewer was consulted. The data were analyzed to calculate sensitivity, specificity, positive and negative predictive values, as well as overall accuracy and to evaluate interreader variability. The absolute Hounsfield unit (HU) differences of the GSs and bile were compared between polychromatic (PC), virtual noncontrast (VNC), and virtual monochromatic (VMC) images.ResultsConsidering at least 3-reader agreement, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were found to be 92%, 96%, 96%, 92%, and 94%, respectively. Individual reader sensitivity varied between 87% and 92%. There was good interobserver agreement with a Fleiss' kappa of 0.76. Quantification of the whole data set showed that no significant difference was observed in the HU values for the stones between the PC images and the VNC images. A significant increase was observed on the 50-keV VMC images compared with the PC and VNC images. In the study group, 17% stones were visualized only on the VNC or/and 50-keV VMC images, and not on the PC images. On quantitative analysis of these cases, there was a significant increase of HU in the VNC images as compared with PC images and a significant decrease of HU in the 50-keV VMC images as compared with PC images.ConclusionsLow-keV images increase stone-bile contrast. Evaluation of cholelithiasis using VNC and 50-keV VMC images demonstrated a 14% increase in sensitivity relative to conventional CT.

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6 citations in Web of Science
7 citations in Scopus

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Web of Science research areas
Radiology, Nuclear Medicine & Medical Imaging
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