Gallstones Detection on Dual-Energy Computerized Tomography-Is It Ready for Real-World Use? A Retrospective...

Area of Science:

• Radiology
• Medical Imaging
• Gastroenterology

Background:

• Gallstones (GSs) are common, and accurate detection is crucial for diagnosis and management.
• Noncalcified gallstones can be challenging to detect with conventional imaging techniques.

Purpose of the Study:

• To evaluate the performance of dual-energy computed tomography (DECT) in detecting noncalcified gallstones (GSs).
• To compare the efficacy of DECT with transabdominal ultrasound (US) for identifying cholelithiasis.

Main Methods:

• Retrospective review of radiology records and images for patients with both US and DECT scans.
• DECT scans were independently reviewed by four radiologists blinded to US results.
• Analysis included sensitivity, specificity, predictive values, accuracy, and interreader variability.

Main Results:

• DECT demonstrated high diagnostic performance with 92% sensitivity, 96% specificity, and 94% overall accuracy.
• Good interobserver agreement was observed (Fleiss' kappa = 0.76).
• Virtual noncontrast (VNC) and 50-keV virtual monochromatic (VMC) images showed improved visualization of stones compared to conventional CT, increasing sensitivity by 14%.

Conclusions:

• DECT is a highly accurate imaging modality for detecting noncalcified gallstones.
• Low-keV VMC and VNC imaging enhance stone-bile contrast, improving sensitivity for cholelithiasis detection over conventional CT.