J Korean Soc Radiol.  2016 Oct;75(4):276-284. 10.3348/jksr.2016.75.4.276.

Effectiveness of Virtual Non-Enhanced Images Acquired by Dual-Energy Computed Tomography in Evaluation of Patients with Suspected Acute Appendicitis

Affiliations
  • 1Department of Radiology, Wonkwang University Hospital, Iksan, Korea. yjyh@wonkwang.ac.kr

Abstract

PURPOSE
To determine whether virtual non-enhanced (VNE) images derived from dual-energy computed tomography (DECT) can replace true non-enhanced (TNE) images in patients with suspected acute appendicitis.
MATERIALS AND METHODS
A total of 195 patients were scanned using DECT. Two radiologists reviewed the VNE set (VNE and portal-phase images) and the TNE set (TNE and portal-phase images), 4 weeks later. Sensitivities and specificities for the diagnosis of acute appendicitis and radiation doses for each set were calculated. Image quality and artifacts in the VNE set were rated on a four point scale (1 = poor-4 = excellent). Size and attenuation of intraperitoneal calcifications were compared in each image.
RESULTS
A total of 114 patients were diagnosed with acute appendicitis by operation. In the VNE set, sensitivity and specificity were 99.1% and 89.9% for reader 1, and 96.6% and 94.8% for reader 2, respectively. In the TNE set, the corresponding values were 96.6% and 94.9% for reader 1, and 94.8% and 92.4% for reader 2, respectively. Among the 87 calcifications detected in the TNE set, 74 calcifications were noted in the VNE set. Mean image quality and artifact were 3.61 and 3.83, respectively. Radiation dose reduction was 48% after excluding the TNE set.
CONCLUSION
Image quality and diagnostic performance of the VNE set were not inferior to those of the TNE set. Replacing TNE images by VNE images can reduce the radiation dose in evaluation of patients with acute appendicitis.


MeSH Terms

Appendicitis*
Artifacts
Diagnosis
Humans
Radiography, Dual-Energy Scanned Projection
Sensitivity and Specificity
Tomography, X-Ray Computed
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