Diagnostic accuracy of virtual non-contrast enhanced dual-energy CT for diagnosis of adrenal adenoma: A systematic review and meta-analysis

Purpose: In this systematic review and meta-analysis, we aimed to investigate the accuracy of dual-energy computed tomography (DECT) in the detection of acute pulmonary embolism (PE). Methods: We searched Medline (via PubMed), EBSCO, Web of Science, Scopus, and the Cochrane Library for relevant published studies. We selected studies assessing the accuracy of DECT in the detection of PE. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies-2 tool. Meta-analysis was performed to calculate mean estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR). The summary receiver operating characteristic (sROC) curve was drawn to get the Cochran Q-index and the area under the curve (AUC). Results: Seven studies were included in our systematic review. Of the 182 patients included, 108 patients had PEs. The pooled analysis showed an overall sensitivity and specificity of 88.9% (95% confidence interval [CI]: 81.4%-94.1%) and 94.6% (95% CI: 86.7%-98.5%), respectively. The pooled PLR was 8.186 (95% CI: 3.726-17.986), while the pooled NLR was 0.159 (95% CI: 0.093-0.270). Cochran-Q was 0.8712, and AUC was 0.935 in the sROC curve. Conclusion: Dual-energy computed tomography shows high sensitivity, specificity, and diagnostic accuracy in the detection of acute PE. The high PLR highlights the high clinical importance of DECT as a prevalence-independent, rule-in test. Studies with a larger sample size with standardized reference tests are still needed to increase the statistical power of the study and support these findings.

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Diagnostic Value of Dual-Energy CT in Differentiating Malignant and Benign Thyroid Nodules: A Systematic Review and Meta-Analysis

Journal of Biosciences and Medicines ◽

10.4236/jbm.2021.94005 ◽

2021 ◽

Vol 09 (04) ◽

pp. 54-76

Author(s):

Kunlin Ye ◽

Yongyao Kuang ◽

Jianye Liang ◽

Xi Xu ◽

Changzheng Shi ◽

...

Keyword(s):

Systematic Review ◽

Thyroid Nodules ◽

Meta Analysis ◽

Diagnostic Value ◽

Dual Energy ◽

Dual Energy Ct ◽

Benign Thyroid Nodules ◽

Benign Thyroid

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Diagnostic accuracy of color-coded virtual noncalcium reconstructions derived from portal venous phase dual-energy CT in the assessment of lumbar disk herniation

European Radiology ◽

10.1007/s00330-021-08354-2 ◽

2021 ◽

Author(s):

Vitali Koch ◽

Moritz H. Albrecht ◽

Leon D. Gruenewald ◽

Ibrahim Yel ◽

Katrin Eichler ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Dual Energy ◽

Dual Energy Ct ◽

Disk Herniation ◽

Lumbar Disk Herniation ◽

Portal Venous Phase ◽

Lumbar Disk ◽

Contrast Enhanced ◽

Dual Source ◽

Venous Phase

Abstract Objectives To investigate the diagnostic accuracy of color-coded contrast-enhanced dual-energy CT virtual noncalcium (VNCa) reconstructions for the assessment of lumbar disk herniation compared to unenhanced VNCa imaging. Methods A total of 91 patients were retrospectively evaluated (65 years ± 16; 43 women) who had undergone third-generation dual-source dual-energy CT and 3.0-T MRI within an examination interval up to 3 weeks between November 2019 and December 2020. Eight weeks after assessing unenhanced color-coded VNCa reconstructions for the presence and degree of lumbar disk herniation, corresponding contrast-enhanced portal venous phase color-coded VNCa reconstructions were independently analyzed by the same five radiologists. MRI series were additionally analyzed by one highly experienced musculoskeletal radiologist and served as reference standard. Results MRI depicted 210 herniated lumbar disks in 91 patients. VNCa reconstructions derived from contrast-enhanced CT scans showed similar high overall sensitivity (93% vs 95%), specificity (94% vs 95%), and accuracy (94% vs 95%) for the assessment of lumbar disk herniation compared to unenhanced VNCa images (all p > .05). Interrater agreement in VNCa imaging was excellent for both, unenhanced and contrast-enhanced CT (κ = 0.84 vs κ = 0.86; p > .05). Moreover, ratings for diagnostic confidence, image quality, and noise differed not significantly between unenhanced and contrast-enhanced VNCa series (all p > .05). Conclusions Color-coded VNCa reconstructions derived from contrast-enhanced dual-energy CT yield similar diagnostic accuracy for the depiction of lumbar disk herniation compared to unenhanced VNCa imaging and therefore may improve opportunistic retrospective lumbar disk herniation assessment, particularly in case of staging CT examinations. Key Points • Color-coded dual-source dual-energy CT virtual noncalcium (VNCa) reconstructions derived from portal venous phase yield similar high diagnostic accuracy for the assessment of lumbar disk herniation compared to unenhanced VNCa CT series (94% vs 95%) with MRI serving as a standard of reference. • Diagnostic confidence, image quality, and noise levels differ not significantly between unenhanced and contrast-enhanced portal venous phase VNCa dual-energy CT series. • Dual-source dual-energy CT might have the potential to improve opportunistic retrospective lumbar disk herniation assessment in CT examinations performed for other indications through reconstruction of VNCa images.

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Diagnostic Accuracy of Dual-energy CT for Bone Marrow Edema in Patients with Acute Knee Injuries: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-1108135/v1 ◽

2021 ◽

Author(s):

Xuelong Chen ◽

Zhizhuo Li ◽

Hui Fang ◽

Xiangyang Yin ◽

Chengxin Li ◽

...

Keyword(s):

Systematic Review ◽

Bone Marrow ◽

Knee Injury ◽

Bone Marrow Edema ◽

Meta Analysis ◽

Knee Injuries ◽

Dual Energy ◽

Dual Energy Ct ◽

Acute Knee ◽

Marrow Edema

Abstract Background: The prevalence of knee injury is high and early diagnosis is significant to guide clinical treatment. MRI is recognized as the gold standard for detecting bone marrow edema (BME) in patients with acute knee injury, but limitations still exist. Dual-energy CT (DECT) is investigated as a promising alternative.Methods: We systematically retrieved studies from EMBASE, Scopus, PUBMED, and the Cochrane Library and collected gray literatures. According to PRISMA-DTA guidelines, a systematic review was performed from inception to July 31, 2021, assessing the diagnostic accuracy of DECT for detecting BME in at least 10 adult patients with acute knee injuries and with an MRI reference standard. Study details were independently extracted by two reviewers. Meta-analysis was performed using a bivariate mixed-effects regression model with subgroup analysis performed to evaluate for sources of variability. Results: Nine studies evaluating 290 patients between the ages of 23–53 with acute knee injuries undergoing DECT and MRI were included in analysis. Summary sensitivity, specificity, and AUC values for BME were 85% (95% confidence interval (CI) 77–90%), 96% (95% CI 93–97%), and 0.97 (95% CI 0.95–0.98), respectively. There were no statistically significant differences in specificity and sensitivity amongst comparative subgroups to account for presumed variability amongst studies.Conclusion: DECT is accurate for detecting BME in patients with acute knee injuries and can be used as an alternative to MRI, particularly when MRI is contraindicated or unavailable.

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