{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T20:28:42Z","timestamp":1784320122643,"version":"3.55.0"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T00:00:00Z","timestamp":1659571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The objective of this study was to investigate subtraction images from different polychromatic and virtual monochromatic reconstructions of dual-energy computed tomography (CT) for the detection of inflammation (synovitis\/tenosynovitis or peritendonitis) in patients with hand arthritis. In this IRB-approved prospective study, 35 patients with acute hand arthritis underwent contrast-enhanced dual-energy CT and musculoskeletal ultrasound (MSUS) of the clinically dominant hand. CT subtractions (CT-S) were calculated from 80 and 135 kVp source data and monochromatic 50 and 70 keV images. CT-S and MSUS were scored for synovitis and tenosynovitis\/peritendonitis. Specificity, sensitivity and diagnostic accuracy were assessed by using MSUS as a reference. Parameters of objective image quality were measured. Thirty-three patients were analyzed. MSUS was positive for synovitis and\/or tenosynovitis\/peritendonitis in 28 patients. The 70 keV images had the highest diagnostic accuracy, with 88% (vs. 50 keV, 82%; 80 kVp, 85%; and 135 kVp, 82%), and superior sensitivity, with 96% (vs. 50 keV: 86%, 80 kVp: 93% and 135 kVp: 79%). The 80 kVp images showed the highest signal- and contrast-to-noise ratio, while the 50 keV images provided the lowest image quality. While all subtraction methods of contrast-enhanced dual-energy CT proved to be able to detect inflammation with sufficient diagnostic accuracy, virtual monochromatic images with low keV showed no significant improvement over conventional subtraction techniques and lead to a loss of image quality.<\/jats:p>","DOI":"10.3390\/diagnostics12081891","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T21:52:48Z","timestamp":1659649968000},"page":"1891","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Virtual Monochromatic Images from Dual-Energy Computed Tomography Do Not Improve the Detection of Synovitis in Hand Arthritis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3871-3746","authenticated-orcid":false,"given":"Sevtap Tugce","family":"Ulas","sequence":"first","affiliation":[{"name":"Department of Radiology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Campus Mitte, Humboldt-Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9763-2420","authenticated-orcid":false,"given":"Katharina","family":"Ziegeler","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Campus Mitte, Humboldt-Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia-Theresa","family":"Richter","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Campus Mitte, Humboldt-Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Ohrndorf","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Campus Mitte, Humboldt-Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-033X","authenticated-orcid":false,"given":"Fabian","family":"Proft","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Humboldt-Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4537-6015","authenticated-orcid":false,"given":"Denis","family":"Poddubnyy","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Campus Benjamin Franklin, Humboldt-Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3593-1449","authenticated-orcid":false,"given":"Torsten","family":"Diekhoff","sequence":"additional","affiliation":[{"name":"Department of Radiology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Campus Mitte, Humboldt-Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,4]]},"reference":[{"key":"ref_1","first-page":"958","article-title":"Dual-energy CT: A new imaging modality for bone marrow oedema in rheumatoid arthritis","volume":"77","author":"Jans","year":"2018","journal-title":"Ann. 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