Evidence map›Paper›PMID 42391232›Full record

ArticlePloS one2026

Evaluation of anemia in non-enhanced and contrast-enhanced dual-energy CT using electron density imaging.

Cherry Kim, Suk Keu Yeom, Hangseok Choi, Euddeum Shim, Sung Ho Hwang, Hwan Seok Yong, Marly van Assen, Carlo N De Cecco, Hwa Jung Sung, Se Ryeon Lee

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Cherry KimDepartment of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-3361-5496
Suk Keu YeomDepartment of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi-do, South Korea.ORCID https://orcid.org/0000-0002-3390-9793
Hangseok ChoiMedical Science Research Center, Korea University College of Medicine, Goryeodae-ro, Seongbuk-gu, South Korea.ORCID https://orcid.org/0000-0001-7412-8160
Euddeum ShimDepartment of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi-do, South Korea.
Sung Ho HwangDepartment of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Hwan Seok YongDepartment of Radiology, Guro Hospital, Korea University College of Medicine, Seoul, South Korea.ORCID https://orcid.org/0000-0003-0247-8932
Marly van AssenDepartment of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America.
Carlo N De CeccoTranslational Laboratory for Cardiothoracic Imaging and Artificial Intelligence, Emory University School of Medicine, Atlanta, Georgia, United States of America.
Hwa Jung SungDepartment of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi-do, South Korea.
Se Ryeon LeeDepartment of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan-si, Gyeonggi-do, South Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Electron density (ED) imaging derived from dual-energy CT (DECT) quantifies tissue composition and may reflect changes in red blood cell (RBC) mass associated with anemia. This study aimed to evaluate the utility of ED from DECT in assessing anemia severity using both non-enhanced CT (NECT) and contrast-enhanced CT (CECT), and to investigate its correlation with hemoglobin (Hb), hematocrit (Hct), and RBC count. In this retrospective study, 2,558 patients who underwent NECT and 2,545 who underwent CECT using a dual-layer spectral detector CT (Philips IQon) were included. Mean ED and mean CT attenuation (HU) were measured at five cardiac blood pool sites. Spearman's rank correlation analysis was performed between CT measurements and hematologic parameters. Partial correlation analysis adjusting for age and sex and non-parametric bootstrap internal validation were also conducted. Receiver operating characteristic (ROC) curve analysis was performed to determine diagnostic cutoff values for anemia detection. Mean ED significantly decreased with increasing anemia severity in both NECT and CECT cohorts (all p < 0.001). With NECT, mean ED showed positive correlations with Hb, Hct, and RBC count (rs = 0.726-0.770), with AUCs of 0.825-0.956 for anemia detection. With CECT, mean ED retained positive correlations with hematologic parameters (rs = 0.447-0.583), with AUCs of 0.727-0.895, while mean HU showed no meaningful correlation. After adjustment for age and sex, partial correlation coefficients remained substantial (NECT: rs = 0.694; CECT: rs = 0.509 for Hb), and bootstrap internal validation confirmed negligible overfitting bias. ED derived from DECT demonstrated diagnostic utility for anemia detection on NECT, unlike conventional HU, retained clinically relevant associations with hematologic parameters on CECT. ED-based anemia detection on CECT is best conceptualized as opportunistic detection, particularly for severe anemia, supplementary to laboratory testing. These findings require external validation across diverse DECT platforms before broader clinical implementation.

Indexed as

AnemiaContrast MediaTomography, X-Ray ComputedAgedErythrocyte CountFemaleHematocritHemoglobinsHumansMaleMiddle AgedRetrospective StudiesROC CurveContrast MediaHemoglobins

Identifiers

PMID42391232
PMCPMC13327118

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.