{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:02:21Z","timestamp":1779951741697,"version":"3.53.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Radiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The preferred imaging modality for acute left colonic diverticulitis (ALCD) remains controversial. This prospective study compares ultrasonography (US) and computed tomography (CT) in selected patients with clinically suspected mild-to-moderate localised ALCD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Consecutive patients presenting to the emergency department with suspected localised mild-to-moderate ALCD underwent both US and CT within 1\u2005h and before treatment initiation. US and CT examinations were performed and interpreted by three trained abdominal radiologists. A multidisciplinary consensus panel established the reference (\u201cfinal\u201d) diagnosis, against which both tests were compared. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each modality. Agreement between US and CT for severity stratification was also assessed. This study was not designed as a non-inferiority or equivalence analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-three patients were included in the study; 50 (79.4%) had a final diagnosis of ALCD. US correctly identified 47\/50 patients with ALCD, yielding a sensitivity of 97.9%, specificity of 91.7%, PPV of 97.9%, and NPV of 91.7%, while CT showed a sensitivity of 98.0%, specificity of 92.3%, PPV of 98.0%, and NPV of 92.3%. A moderate agreement was found between the two treatment modalities for differentiating stage 0 (mild-to-moderate) from stage &amp;gt;0 (severe) localised ALCD (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.568,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), which increased when US was performed by a more experienced operator (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Higher C-reactive protein levels were associated with higher radiological severity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this selected prospective cohort, ultrasonography performed by experienced abdominal radiologists showed diagnostic estimates similar to CT and identified most ALCD cases. Given the limited sample size, operator dependence, and non-independent reference standard, these findings should be interpreted cautiously and are most applicable to specialised centres with dedicated ultrasound expertise.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Clinical Trial Registration<\/jats:bold>\n                      : ClinicalTrials.gov, NCT05323968.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fradi.2026.1829813","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:15:38Z","timestamp":1779948938000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasonography for suspected mild-to-moderate acute left colonic diverticulitis: a prospective head-to-head study with computed tomography"],"prefix":"10.3389","volume":"6","author":[{"given":"Nuria","family":"Roson","sequence":"first","affiliation":[{"name":"Department of Radiology, Hospital Universitari Vall d\u2019Hebron","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreu","family":"Antolin","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hospital Universitari Vall d\u2019Hebron","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Flores-Yelamos","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Hospital General de Granollers","place":["Granollers, Spain"]},{"name":"Universitat Internacional de Catalunya","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Victoria","family":"Garriga","sequence":"additional","affiliation":[{"name":"Department of Radiology, Institut de Diagn\u00f2stic per la Imatge (IDI), Hospital Universitari Josep Trueta","place":["Girona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Pruna","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hospital General de Granollers","place":["Granollers, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvador","family":"Pedraza","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Lopez-Cano","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Hospital Universitari Vall d\u2019Hebr\u00f3n","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep M.","family":"Badia","sequence":"additional","affiliation":[{"name":"Department of General and Digestive Surgery, Hospital General de Granollers","place":["Granollers, Spain"]},{"name":"Universitat Internacional de Catalunya","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"b2431","DOI":"10.1136\/bmj.b2431","article-title":"Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study","volume":"338","author":"Lam\u00e9ris","year":"2009","journal-title":"Br Med J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1016\/j.cgh.2013.06.020","article-title":"Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy","volume":"11","author":"Shahedi","year":"2013","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"760","DOI":"10.3748\/wjg.v27.i9.760","article-title":"Update on the management of sigmoid diverticulitis","volume":"27","author":"Hanna","year":"2021","journal-title":"World J Gastroenterol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"15","DOI":"10.2214\/AJR.16.16138","article-title":"The current role of radiologic and endoscopic imaging in the diagnosis and follow-up of colonic diverticular disease","volume":"207","author":"Flor","year":"2016","journal-title":"Am J Roentgenol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1097\/SLA.0b013e3181952888","article-title":"Diverticulitis in the United States: 1998\u20132005: changing patterns of disease and treatment","volume":"249","author":"Etzioni","year":"2009","journal-title":"Ann Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2557","DOI":"10.1007\/s00330-003-2013-6","article-title":"Acute colonic diverticulitis: CT or ultrasound?","volume":"13","author":"Bruel","year":"2003","journal-title":"Eur Radiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.rx.2019.05.007","article-title":"Is it useful ultrasonography as the first-line imaging technique in patients with suspected acute diverticulitis?","volume":"61","author":"Mac\u00eda-Su\u00e1rez","year":"2019","journal-title":"Radiologia (Panama)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1097\/SLA.0b013e3182113614","article-title":"How to diagnose acute left-sided colonic diverticulitis: proposal for a clinical scoring system","volume":"253","author":"Andeweg","year":"2011","journal-title":"Ann Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1007\/DCR.0b013e3181d98d86","article-title":"A clinical decision rule to establish the diagnosis of acute diverticulitis at the emergency department","volume":"53","author":"Lam\u00e9ris","year":"2010","journal-title":"Dis Colon Rectum"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1442","DOI":"10.1111\/codi.12449","article-title":"Application of a modified Neff classification to patients with uncomplicated diverticulitis","volume":"15","author":"Mora Lopez","year":"2013","journal-title":"Colorectal Dis"},{"key":"B11","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1148\/radiol.2015151516","article-title":"STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies","volume":"277","author":"Bossuyt","year":"2015","journal-title":"Radiology"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1002\/bjs.11239","article-title":"Long-term follow-up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis","volume":"106","author":"Isacson","year":"2019","journal-title":"Br J Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1002\/bjs.10309","article-title":"Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT-proven uncomplicated acute diverticulitis","volume":"104","author":"Daniels","year":"2017","journal-title":"Br J Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1177\/000313480907501026","article-title":"Diverticulitis in California from 1995 to 2006: increased rates of treatment for younger patients","volume":"75","author":"Etzioni","year":"2009","journal-title":"Am Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1155\/2007\/943460","article-title":"Fourteen-year study of hospital admissions for diverticular disease in Ontario","volume":"21","author":"Warner","year":"2007","journal-title":"Can J Gastroenterol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1002\/jcu.24052","article-title":"Point-of-care ultrasound as a first-line tool for acute diverticulitis in a military setting","volume":"53","author":"Moccia","year":"2025","journal-title":"J Clin Ultrasound"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2498","DOI":"10.1007\/s00330-008-1018-6","article-title":"Graded compression ultrasonography and computed tomography in acute colonic diverticulitis: meta-analysis of test accuracy","volume":"18","author":"Lam\u00e9ris","year":"2008","journal-title":"Eur Radiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"775","DOI":"10.3109\/00365521.2014.908475","article-title":"Toward an evidence-based step-up approach in diagnosing diverticulitis","volume":"49","author":"Andeweg","year":"2014","journal-title":"Scand J Gastroenterol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1159\/000367625","article-title":". Diverticular disease: guidelines of the German society for gastroenterology, digestive and metabolic diseases and the German society for general and visceral surgery","volume":"90","author":"Kruis","year":"2014","journal-title":"Digestion"},{"key":"B20","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s13017-020-00313-4","article-title":"2020 Update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting","volume":"15","author":"Sartelli","year":"2020","journal-title":"World J Emerg Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1159\/000354035","article-title":"Guidelines of diagnostics and treatment of acute left-sided colonic diverticulitis","volume":"30","author":"Andeweg","year":"2014","journal-title":"Dig Surg"},{"key":"B22","first-page":"C4453","article-title":"Danish National guidelines for treatment of diverticular disease","volume":"59","author":"Andersen","year":"2012","journal-title":"Dan Med J"},{"key":"B23","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1055\/a-0824-6952","article-title":"EFSUMB position paper: recommendations for gastrointestinal ultrasound (GIUS) in acute appendicitis and diverticulitis","volume":"40","author":"Dirks","year":"2019","journal-title":"Ultraschall Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"S141","DOI":"10.1016\/j.jacr.2019.02.015","article-title":"ACR appropriateness criteria\u00ae left lower quadrant pain-suspected diverticulitis","volume":"16","author":"Galgano","year":"2019","journal-title":"J Am Coll Radiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1097\/DCR.0000000000000075","article-title":"Practice parameters for the treatment of sigmoid diverticulitis","volume":"57","author":"Feingold","year":"2014","journal-title":"Dis Colon Rectum"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1732","DOI":"10.1007\/s11605-017-3404-3","article-title":"Management of diverticulitis in 2017","volume":"21","author":"Deery","year":"2017","journal-title":"J Gastrointest Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1148\/radiology.205.2.9356636","article-title":"Acute colonic diverticulitis: prospective comparative evaluation with US and CT","volume":"205","author":"Pradel","year":"1997","journal-title":"Radiology"},{"key":"B28","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1111\/codi.12072","article-title":"The value of inflammation markers and body temperature in acute diverticulitis","volume":"15","author":"van de Wall","year":"2013","journal-title":"Colorectal Dis"},{"key":"B29","doi-asserted-by":"publisher","first-page":"3826","DOI":"10.1007\/s00261-021-03060-5","article-title":"Ultrasound can differentiate complicated and noncomplicated acute colonic diverticulitis: a prospective comparative study with computed tomography","volume":"46","author":"Ripoll\u00e9s","year":"2021","journal-title":"Abdom Radiol"}],"container-title":["Frontiers in Radiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2026.1829813\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:15:42Z","timestamp":1779948942000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2026.1829813\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":29,"alternative-id":["10.3389\/fradi.2026.1829813"],"URL":"https:\/\/doi.org\/10.3389\/fradi.2026.1829813","relation":{},"ISSN":["2673-8740"],"issn-type":[{"value":"2673-8740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]},"article-number":"1829813"}}