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Comparison of non-contrast CT vs. contrast-enhanced CT with both intravenous and rectal contrast application for diagnosis of acute colonic diverticulitis: a multireader, retrospective single-center study

Objectives: To evaluate the non-inferiority of non-contrast CT compared to contrast-enhanced CT with both intravenous and rectal contrast application for the diagnosis of acute colonic diverticulitis. Methods: Five readers retrospectively evaluated the non-contrast and contrast-enhanced series of CT...

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Main Authors: Móré, Dorottya (Author) , Erdmann, Stella (Author) , Bischoff, Arved (Author) , Wagner, Verena (Author) , Kauczor, Hans-Ulrich (Author) , Liesenfeld, Lukas (Author) , Abbasi Dezfouli, Katharina (Author) , Giannakis, Athanasios (Author) , Klauß, Miriam (Author) , Mayer, Philipp (Author)
Format: Article (Journal)
Language:English
Published: January 2025
In: Diagnostics
Year: 2025, Volume: 15, Issue: 1, Pages: 1-13
ISSN:2075-4418
DOI:10.3390/diagnostics15010029
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/diagnostics15010029
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2075-4418/15/1/29
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Author Notes:Dorottya More, Stella Erdmann, Arved Bischoff, Verena Wagner, Hans-Ulrich Kauczor, Lukas F. Liesenfeld, Katharina Abbasi Dezfouli, Athanasios Giannakis, Miriam Klauss and Philipp Mayer
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Summary:Objectives: To evaluate the non-inferiority of non-contrast CT compared to contrast-enhanced CT with both intravenous and rectal contrast application for the diagnosis of acute colonic diverticulitis. Methods: Five readers retrospectively evaluated the non-contrast and contrast-enhanced series of CTs of 205 consecutive patients with clinical suspicion of acute diverticulitis. Two randomized reading sessions, both containing all 205 cases as either contrast-enhanced or non-contrast (1:1) series, were performed with >= 8 weeks washout between them. The non-inferiority margin was set to 0.1. Results: The pooled prevalence (all readers) of diverticulitis was similar for non-contrast CT (63.9%, range: 60.5-65.0%) and contrast-enhanced CT (64.4%, 61.5-67.8%). Non-contrast CT was non-inferior for the diagnosis of diverticulitis (accuracy 0.90 [95% confidence interval: 0.89, 0.92]) compared to contrast-enhanced CT (0.92 [0.90, 0.94]; the difference in accuracy: -0.01 [-0.04, 0.01]) (normal deviate test: p-valueone-sided = 5.20 x 10-6). Sensitivities for perforation and abscess were slightly but significantly lower for the non-contrast CT than for the contrast-enhanced CT (differences: -0.15 [-0.20, -0.05], -0.17 [-0.27, -0.07]), while no differences in accuracies and specificities were observed. Conclusions: Non-contrast CT is non-inferior to contrast-enhanced CT (intravenous and rectal contrast) for the diagnosis of acute colonic diverticulitis. Contrast-enhanced CT is associated with significantly higher sensitivities for the presence of an abscess or perforation.
Item Description:Gesehen am 04.04.2025
Online veröffentlicht: 26. Dezember 2024
Physical Description:Online Resource
ISSN:2075-4418
DOI:10.3390/diagnostics15010029

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