ArticleEuropean radiology2023
Preliminary evaluation of dual-energy CT to quantitatively assess bone marrow edema in patients with diabetic foot ulcers and suspected osteomyelitis.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 28 citations in OpenAlex.
- What you don't see matters: dual-energy CT in emergency radiology.Japanese journal of radiology · 2026Review
- Imaging and image-guided intervention of septic arthritis in adults and children.Skeletal radiology · 2025Review
- Diagnostic performance of dual-energy CT for opportunistic detection of rotator cuff disease: a retrospective multireader study.Insights into imaging · 2025Article
- Letter to Editor: Reevaluating DECT in early spondylodiscitis for comprehensive diagnosis.European radiology · 2025Article
- Considering hounsfield units in native CT- scans for diagnosing spondylodiscitis.BMC musculoskeletal disorders · 2025Article
- Dual-Energy Computed Tomography for the Detection of Bone Edema-Like Lesions in the Equine Foot: Standing Horses and Cadaveric Specimens.Veterinary sciences · 2025Article
- Dual-Energy CT and Pedal Osteomyelitis.Radiology · 2025Article
- Diagnostic accuracy of virtual non-calcium dual-energy computed tomography in the detection of acute occult ankle and calcaneus fractures.Quantitative imaging in medicine and surgery · 2025Article
- Spondylodiscitis of the thoraco-lumbar spine: diagnostic performance of dual-energy CT vs MRI.European radiology · 2025Article
- ESR Bridges: building bridges in MSK imaging: dual-energy CT and bone marrow detection-a multidisciplinary view.European radiology · 2025Article
- Immunometabolic reprogramming in diabetic osteomyelitis: from mechanisms to therapeutics.Frontiers in cellular and infection microbiology · 2025Review
- Assessment of bone marrow edema on dual-energy CT scans in people with diabetes mellitus and suspected Charcot neuro-osteoarthropathy.Skeletal radiology · 2025Article
- Lower extremity infections: Essential anatomy and multimodality imaging findings.Skeletal radiology · 2024Review
- The Clinical Utility of Lower Extremity Dual-Energy CT Angiography in the Detection of Bone Marrow Edema in Diabetic Patients with Peripheral Artery Disease.Journal of clinical medicine · 2024Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesThe purpose of this study is to evaluate the value of dual-energy CT (DECT) with virtual non-calcium (VNCa) in quantitatively assessing the presence of bone marrow edema (BME) in patients with diabetic foot ulcers and suspected osteomyelitis.
methodsPatients with a diabetic foot ulcer and suspected osteomyelitis that underwent DECT (80 kVp/Sn150 kVp) with VNCa were retrospectively included. Two observers independently measured CT values of the bone adjacent to the ulcer and a reference bone not related to the ulcer. The patients were divided into two clinical groups, osteomyelitis or no-osteomyelitis, based on the final diagnosis by the treating physicians.
resultsA total of 56 foot ulcers were identified of which 23 were included in the osteomyelitis group. The mean CT value at the ulcer location was significantly higher in the osteomyelitis group (- 17.23 ± 34.96 HU) compared to the no-osteomyelitis group (- 69.34 ± 49.40 HU; p < 0.001). Within the osteomyelitis group, the difference between affected bone and reference bone was statistically significant (p < 0.001), which was not the case in the group without osteomyelitis (p = 0.052). The observer agreement was good for affected bone measurements (ICC = 0.858) and moderate for reference bone measurements (ICC = 0.675). With a cut-off value of - 40.1 HU, sensitivity was 87.0%, specificity was 72.7%, PPV was 69.0%, and NPV was 88.9%.
conclusionDECT with VNCa has a potential value for quantitatively assessing the presence of BME in patients with diabetic foot ulcers and suspected osteomyelitis. KEY POINTS: • Dual-energy CT (DECT) with virtual non-calcium (VNCa) is promising for detecting bone marrow edema in the case of diabetic foot ulcers with suspected osteomyelitis. • DECT with VNCa has the potential to become a more practical alternative to MRI in assessing the presence of bone marrow edema in suspected osteomyelitis when radiographs are not sufficient to form a diagnosis.
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