{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:56:06Z","timestamp":1781564166284,"version":"3.54.5"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rofo"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To retrospectively evaluate the diagnostic performance and confidence of photon-counting computed tomography (PCCT) for detecting bone marrow edema (BME) in trauma patients, using magnetic resonance imaging (MRI) as the reference standard.<\/jats:p>\n                  <jats:p>In this exploratory, bone-region-level analysis, a selected pilot cohort of ten patients (mean age 56.2 years, 80% female) underwent both PCCT and MRI of peripheral joints within a 10-day interval. A total of 123 bone regions across the knee, pelvis\/hip, wrist\/hand, and elbow were analyzed. Two readers, blinded to clinical and MRI findings, independently assessed BME on PCCT using color-coded maps and standard images, recording diagnostic confidence on a 5-point Likert scale. MRI served as the reference for BME. Sensitivity, specificity, predictive values, accuracy, and interrater agreement (weighted Cohen\u2019s \u03ba) were calculated.<\/jats:p>\n                  <jats:p>BME was present in all patients and in 28.5% (35\/123) of bone regions on MRI. For PCCT, Reader 1 achieved a sensitivity of 0.63 (95% CI: 0.46\u20130.77), specificity of 0.97 (0.90\u20130.99), and accuracy of 0.87 (0.80\u20130.92) and Reader 2 achieved a sensitivity of 0.57 (0.41\u20130.72), specificity of 0.97 (0.91\u20130.99), and accuracy of 0.85 (0.78\u20130.91). Diagnostic specificity exceeded 0.93 across all joints, with the highest sensitivity in the knee. Inter-rater agreement was substantial (\u03ba = 0.74). Both readers reported high diagnostic confidence. Reader 1 showed significantly higher confidence in correct classifications (p = 0.0017), whereas Reader 2 showed no significant difference between correct and incorrect classifications (p = 0.89).<\/jats:p>\n                  <jats:p>PCCT showed high specificity but only moderate sensitivity for BME detection at the bone-region level, particularly in large joints. These preliminary findings suggest that the high specificity of PCCT may support confirmation of BME in selected clinical scenarios when MRI is unavailable, contraindicated, or redundant. However, moderate sensitivity requires continued clinical vigilance and MRI confirmation for negative or equivocal findings. Larger validation studies are warranted.<\/jats:p>","DOI":"10.1055\/a-2888-7989","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:50:57Z","timestamp":1781563857000},"source":"Crossref","is-referenced-by-count":0,"title":["Exploratory Evaluation of Photon-Counting CT for Bone Marrow Edema Detection Across Multiple Joints: A Pilot Study"],"prefix":"10.1055","author":[{"given":"Iram","family":"Shahzadi","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3894-8630","authenticated-orcid":false,"given":"Georg","family":"Reimann","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Schneider","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Roggel","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0103-3819","authenticated-orcid":false,"given":"Julius Henning","family":"Niehoff","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Robert","family":"Kr\u00f6ger","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Panknin","sequence":"additional","affiliation":[{"name":"Siemens Healthineers AG, Germany","place":["Forchheim"],"department":["Scientific Collaborations"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2908-7560","authenticated-orcid":false,"given":"Jan","family":"Borggrefe","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexey","family":"Surov","sequence":"additional","affiliation":[{"name":"Ruhr University Bochum, Germany","place":["Minden"],"department":["Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.crad.2020.08.006","article-title":"Dual-energy CT in musculoskeletal trauma","volume":"76","author":"AJN Wong","year":"2021","journal-title":"Clinical Radiology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1007\/s00296-011-2141-2","article-title":"Bone marrow lesions: a universal bone response to injury?","volume":"32","author":"EF Eriksen","year":"2012","journal-title":"Rheumatol 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Exp"},{"key":"ref6","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejrad.2020.109385","article-title":"Diagnostic accuracy of dual-energy CT virtual non-calcium images with different related contrast material values for the detection of bone marrow edema in knee","volume":"133","author":"J Liang","year":"2020","journal-title":"European Journal of Radiology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.1007\/s00330-020-07236-3","article-title":"Diagnostic accuracy of dual-energy CT for the detection of bone marrow edema in the appendicular skeleton: a systematic review and meta-analysis","volume":"31","author":"MP Wilson","year":"2021","journal-title":"Eur Radiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"4098","DOI":"10.1007\/s00330-020-06775-z","article-title":"Bone marrow edema around the hip in non-traumatic pain: dual-energy CT vs MRI","volume":"30","author":"G Foti","year":"2020","journal-title":"Eur Radiol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1148\/radiol.2021203624","article-title":"DECT in Detection of Vertebral Fracture\u2013associated Bone Marrow Edema: A Systematic Review and Meta-Analysis with Emphasis on Technical and Imaging Interpretation Parameters","volume":"300","author":"F Ghazi Sherbaf","year":"2021","journal-title":"Radiology"},{"key":"ref10","first-page":"1097","article-title":"Dual-source dual-energy imaging using photon-counting detector CT FOR bone edema detection: Leveraging tin prefiltration for improved spectral performance","volume":"10","author":"K Rajendran","year":"2024","journal-title":"Investigative radiology"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.230344","article-title":"Musculoskeletal CT Imaging: State-of-the-Art Advancements and Future Directions","volume":"308","author":"S Demehri","year":"2023","journal-title":"Radiology"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1097\/RLI.0000000000001108","article-title":"Photon-counting detector CT applications in musculoskeletal radiology","volume":"60","author":"J-P Grunz","year":"2025","journal-title":"Investigative Radiology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1055\/a-2312-6914","article-title":"Photon-counting detector CT \u2013 first experiences in the field of musculoskeletal radiology","volume":"197","author":"S Bette","year":"2025","journal-title":"Rofo"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.231878","article-title":"Bone Marrow Edema at Photon-Counting CT","volume":"310","author":"A Surov","year":"2024","journal-title":"Radiology"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s41747-025-00604-y","article-title":"Photon-counting CT versus energy-integrating detector and flat-panel CT for cadaveric wrist arthrography with additional tin filter dose reduction","volume":"9","author":"J De Boer","year":"2025","journal-title":"Eur Radiol Exp"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"15","DOI":"10.12974\/2313-0954.2023.09.03","article-title":"Non-Traumatic Bone Marrow Edema of the Knee: Diagnostic Accuracy of Dual-Energy Computed Tomography in Comparison to MRI","volume":"9","author":"G Foti","year":"2023","journal-title":"International Journal of Orthopedics and Rehabilitation"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1097\/RLI.0000000000000980","article-title":"Technical basics and clinical benefits of photon-counting CT","volume":"58","author":"T Flohr","year":"2023","journal-title":"Investigative radiology"}],"container-title":["R\u00f6Fo - Fortschritte auf dem Gebiet der R\u00f6ntgenstrahlen und der bildgebenden Verfahren"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2888-7989.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:50:58Z","timestamp":1781563858000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2888-7989"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":17,"URL":"https:\/\/doi.org\/10.1055\/a-2888-7989","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1438-9029","1438-9010"],"issn-type":[{"value":"1438-9029","type":"print"},{"value":"1438-9010","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}