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
<b>Objectives</b>: 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. <b>Methods</b>: Five readers retrospectively evaluated the non-contr...
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2024-12-01
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| author | Dorottya Móré Stella Erdmann Arved Bischoff Verena Wagner Hans-Ulrich Kauczor Lukas F. Liesenfeld Katharina Abbasi Dezfouli Athanasios Giannakis Miriam Klauß Philipp Mayer |
| author_facet | Dorottya Móré Stella Erdmann Arved Bischoff Verena Wagner Hans-Ulrich Kauczor Lukas F. Liesenfeld Katharina Abbasi Dezfouli Athanasios Giannakis Miriam Klauß Philipp Mayer |
| author_sort | Dorottya Móré |
| collection | DOAJ |
| description | <b>Objectives</b>: 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. <b>Methods</b>: 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. <b>Results</b>: 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: <i>p</i>-value<sub>one-sided</sub> = 5.20 × 10<sup>−6</sup>). 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. <b>Conclusions</b>: 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. |
| format | Article |
| id | doaj-art-c999a069af96410b9215bfe5be0889a0 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
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| series | Diagnostics |
| spelling | doaj-art-c999a069af96410b9215bfe5be0889a02025-01-10T13:16:30ZengMDPI AGDiagnostics2075-44182024-12-011512910.3390/diagnostics15010029Comparison 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 StudyDorottya Móré0Stella Erdmann1Arved Bischoff2Verena Wagner3Hans-Ulrich Kauczor4Lukas F. Liesenfeld5Katharina Abbasi Dezfouli6Athanasios Giannakis7Miriam Klauß8Philipp Mayer9Diagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, GermanyInstitute of Medical Biometry, University of Heidelberg, 69120 Heidelberg, GermanyDiagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDiagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDiagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, 69120 Heidelberg, GermanyDiagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDiagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDiagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, GermanyDiagnostic and Interventional Radiology, Heidelberg University Hospital, 69120 Heidelberg, Germany<b>Objectives</b>: 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. <b>Methods</b>: 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. <b>Results</b>: 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: <i>p</i>-value<sub>one-sided</sub> = 5.20 × 10<sup>−6</sup>). 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. <b>Conclusions</b>: 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.https://www.mdpi.com/2075-4418/15/1/29colonic diverticulitiscomputed tomographynon-contrast computed tomographycontrast enemareader study |
| spellingShingle | Dorottya Móré Stella Erdmann Arved Bischoff Verena Wagner Hans-Ulrich Kauczor Lukas F. Liesenfeld Katharina Abbasi Dezfouli Athanasios Giannakis Miriam Klauß Philipp Mayer 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 Diagnostics colonic diverticulitis computed tomography non-contrast computed tomography contrast enema reader study |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | colonic diverticulitis computed tomography non-contrast computed tomography contrast enema reader study |
| url | https://www.mdpi.com/2075-4418/15/1/29 |
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