{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:22:56Z","timestamp":1789690976266,"version":"4.0.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This study evaluates the advantages in diagnostic accuracy, confidence, and reading time of additional dual-energy CT-derived reconstructions for assessing acute bowel ischemia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and materials<\/jats:title>\n            <jats:p>This retrospective study includes 25 patients with surgically proven acute bowel ischemia and 25 gender- and age-matched controls who underwent biphasic abdominal dual-energy CT. Two fellowship-trained abdominal radiologists and two residents evaluated all cases with and without additional dual-energy CT-derived iodine maps and virtual non-contrast images. Diagnostic confidence was rated on a 10-point Likert scale. Reading time was recorded. The inter-reader agreement was assessed using Fleiss\u2019 kappa. Sensitivity and specificity were compared using McNemar\u2019s test, reader confidence, and reading times with the Wilcoxon signed-rank test.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>For conventional images alone, the inter-reader agreement was moderate (<jats:italic>\u03ba<\/jats:italic> = 0.58), with a sensitivity of 77% (95% CI: 67.5\u201384.8%) and specificity of 90% (95% CI: 82.4\u201395.1%). Adding dual-energy CT images, inter-reader agreement increased to substantial (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.69), sensitivity increased significantly to 89% (95% CI: 81.2\u201394.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.02), while specificity increased non-significantly to 93% (95% CI: 86.1\u201397.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.51). Diagnostic confidence increased significantly from 8 (IQR: 6\u20138) to 9 (IQR: 8\u20139) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Equivalent diagnostic accuracy and confidence increases were observed for fellowship-trained and resident radiologists. A non-significant increase in mean reading time per case from 196\u2009s to 201\u2009s was observed (<jats:italic>p<\/jats:italic>\u2009=\u20090.30).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Additional dual-energy CT reconstructions increase diagnostic accuracy and confidence without increasing reading time when evaluating suspected acute bowel ischemia. Both experienced and resident readers benefit from dual-energy CT images.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Question<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>There are too few clinical studies assessing the diagnostic accuracy of dual-energy CT (DECT) to recommend its use for evaluating suspected acute bowel ischemia<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Findings<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Adding DECT-derived iodine maps and virtual-non-contrast images increase reader sensitivity and confidence while maintaining high specificity when evaluating for acute mesenteric ischemia<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Clinical relevance<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Dual-energy CT should be used to investigate suspected acute bowel ischemia. Both diagnostic accuracy and confidence can be increased independent of reader experience without significantly increasing reading time<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00330-024-11217-1","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:23:12Z","timestamp":1732666992000},"page":"1405-1414","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Dual-energy CT of acute bowel ischemia\u2014influence on diagnostic accuracy and reader confidence"],"prefix":"10.1007","volume":"35","author":[{"given":"Moritz","family":"Oberparleiter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Vosshenrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanns-Christian","family":"Breit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Kaiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Hehenkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothee","family":"Harder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel T.","family":"Boll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph J.","family":"Zech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6586-0034","authenticated-orcid":false,"given":"Markus M.","family":"Obmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,11,27]]},"reference":[{"key":"11217_CR1","doi-asserted-by":"publisher","unstructured":"Bala M, Kashuk J, Moore EE et al (2017) Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. 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Obmann.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"J.V. is a member of the Scientific Editorial Board of European Radiology (section: vascular-interventional). They did not participate in the selection or review processes for this article. The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"None of the study subjects or cohorts have been previously reported on.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}