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. 2025 Sep;130(9):1396-1408.
doi: 10.1007/s11547-025-02044-5. Epub 2025 Jul 15.

Italian radiologists and dual-energy CT: a state of the art from a shared document by the computed tomography subspecialty section of the Italian society of radiology

Maria Antonietta Mazzei  1   2 , Alfonso Cerase  3 , Giulio Bagnacci  4   5 , Armando Perrella  2 , Nunzia Di Meglio  6 , Francesco Giuseppe Mazzei  7 , Luca Volterrani  1   2 , Giulia A Zamboni  1   8 , Michaela Cellina  1   9 , Susanna Guerrini  1   10 , Giuseppe Minetti  1   11 , Laura Maria Cacioppa  1   12 , Giorgio Ascenti  13 , Chiara Floridi  1   12 , Andrea Giovagnoni  12 ; Italian Society of Medical and Interventional Radiology partecipants; Teresa Arcadi  14 , Giovanni Maria Argiolas  15 , Francesco Marcello Arico  16 , Velio Ascenti  17 , Luca Ausili Cefaro  18 , Vittoria Balletta  19 , Claudia Barillà  20 , Stefano Bastaniello  21 , Eugenio Belatti  22 , Raffaele Bisogno  23 , Giovanni Bonenti  24 , Antonio Bottari  20 , Pasquale Bufano  19 , Guido Buonomenna  25 , Cristina Calandra  26 , Tanio Campagnuolo  27 , Delia Campanella  28 , Roberto Cannella  29 , Danilo Caudo  30 , Giuseppe Cicero  16 , Giuseppe Cittadini  31 , Valeria Consoli  32 , Tommaso D'Angelo  20 , Annemilia Del Ciello  33 , Vito Di Martino  19 , Margherita Di Stefano  19 , Alessandra Farchione  33 , Antonio Pio Francioso  34 , Barbara Frittoli  35 , Rachele Fruzza  19 , Valeria Garufi  19 , Chiara Gennari  36 , Francesco Gentili  37 , Ivan Gigantelli  38 , Mariangela Iodice  39 , Anna Rita Larici  33   40 , Enrica Liguori  19 , Stefano Lofino  41 , Antonio Lo Tito  42 , Nicola Maggialetti  41 , Francesca Menchini  43 , Cinzia Micheli  44 , Vittorio Miele  45 , Nicola Migliaccio  16 , Bruno Minopoli  46 , Ilaria Monteleone  37 , Emanuele Neri  47 , Luca Panebianco  48 , Fabio Perotto  49 , Matteo Pignatelli  50 , Andrea Pisano  51 , Gabriele Polonara  32 , Giuseppe Posillico  39 , Sergio Racchiusa  16 , Lorenzo Santini  19 , Francesco Secchi  52   53 , Cristian Sica  19 , Salvatore Silipigni  16 , Carmelo Sofia  20 , Alberto Stagno  16 , Silvia Storer  14 , Corrado Tagliati  54 , Ilaria Tanga  50 , Francesco Testa  55 , Michele Tonerini  56 , Giorgio Torrigiani  19 , Chiara Torrisi  23 , Francesco Toscano  16 , Silvia Tresoldi  57 , Umberto Tupputi  58 , Francesco Verde  59 , Carlo Zanolini  60 , Fabio Zecca  61
Affiliations

Italian radiologists and dual-energy CT: a state of the art from a shared document by the computed tomography subspecialty section of the Italian society of radiology

Maria Antonietta Mazzei et al. Radiol Med. 2025 Sep.

Abstract

Objective: The main objective was to assess the geographical distribution and main areas of use of dual-energy CT (DECT) scanners in Italy prior to the implementation of the National Recovery and Resilience Plan (NRRP) within the Next Generation EU (NGEU) framework. Secondary objectives included the level of knowledge of DECT among radiologists and some possible solutions to maximize its use.

Methods: Between February and March 2022, an anonymous questionnaire was conducted among the members of the Italian Society of Medical and Interventional Radiology (SIRM), using the Google form platform.

Results: A total of 261 radiologists (mean age 41 ± 11.7 years) from 90 Italian cities participated in the questionnaire. 42% of them worked in an academic center, and diagnostic imaging was the main area of work for most participants (87%). Most radiologists had some knowledge gap, especially those who did not have a DECT scanner available in their hospital (48.3%). Weekly use of DECT protocols varied widely between centers. Oncological imaging (70.4%) was the main area of use. Radiologists use DECT to improve contrast resolution (65.9%), characterize materials (64.4%), and reduce the amount of contrast agent (60%). 91.1% of participants reported that DECT improved their diagnostic accuracy.

Conclusion: DECT scanners have become increasingly available in Italy in recent years, and their number is expected to increase with the NRRP. There is a wide variation in their use and in the expertise of radiologists, leading to a huge untapped potential, that can be improved by specific training. A similar questionnaire will be conducted at the end of the NRRP in 2027.

Keywords: Computed Tomography; Dual-Energy computed tomography; National Recovery and Resilience Plan; Next Generation EU.

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Conflict of interest statement

Declarations. Conflict of interest: The authors Laura Maria Cacioppa, Michaela Cellina, Chiara Floridi, Andrea Giovagnogni, and Maria Antonietta Mazzei, are members of the Editorial Board and Deputy Editor panel of the journal La Radiologia Medica. The authors have no other relevant financial or non-financial interests to disclose. Ethical approval: This work was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent to participate: Informed consent was not required as the work was based on voluntary participation in an online questionnaire. Human and animal rights: This article does not contain any studies with humans and animals by any of the authors.

Figures

Fig. 1
Fig. 1
Flow of the questionnaire. Underlined questions were used to address the flow
Fig. 2
Fig. 2
The mean age of the participants was 41 ± 11.7 years. Age distribution and years of experience of radiologists participating in the questionnaire
Fig. 3
Fig. 3
Green markers indicate hospitals where DECT is already available, and red markers indicate those where it is not. Yellow indicates hospitals where a DECT will be installed soon
Fig. 4
Fig. 4
In a the number of CTs in the workplace; in b the availability of a DECT; in c note the linear relationship
Fig. 5
Fig. 5
Evolution of the availability of DECT scanners over the last few years
See this image and copyright information in PMC

References

    1. Regulation of the European Parliament and of the Council n. 241 of 12 February 2021 establishing the Recovery and Resilience Facility, Official Journal of the European Union 18.2.2021, L 57, pp 17–75
    1. European Commission. Next Generation EU Programme. Publishing Web. https://commission.europa.eu/strategy-and-policy/eu-budget/eu-borrower-i...
    1. Italian Decree-Law No. 59 of 6 May 2021. Misure urgenti relative al Fondo complementare al Piano nazionale di ripresa e resilienza e altre misure urgenti per gli investimenti (21G00070) (Official Gazette General Series No. 108 of 07-05-2021)—note: Entrata in vigore del provvedimento: 08/05/2021—Decreto-Legge convertito con modificazioni dalla L. 1 luglio 2021, n. 101 (in Official Gazette No. 160 of 07-06-2021, n. 160)
    1. Italian Republic National Recovery and Resilience Plan (NRRP). #NEXTGENERATIONITALIA. Italia Domani, Publishing Web. https://www.italiadomani.gov.it/en/home.html
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