Diagnostic performance of dual-energy CT in detecting bone marrow edema in lower limb joint injuries: a meta-analysis

Abstract

ObjectiveWe aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) in detecting bone marrow edema (BME) in patients with lower limb joint injuries. MethodsA thorough literature search was conducted across the PubMed, Embase, and Web of Science databases to identify relevant studies up to April 2024. Studies examining the diagnostic performance of DECT in detecting BME in lower limb joint injuries patients were included. Sensitivity and specificity were evaluated using the inverse variance method and transformed via the Freeman-Tukey double arcsine transformation. Furthermore, the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized to evaluate the methodological quality of the included studies. ResultsThis meta-analysis included 17 articles involving 625 patients. The pooled sensitivity, specificity, and AUC for DECT in detecting BME in lower limb joint injuries patients were 0.82 (95 % CI: 0.76–0.87), 0.95 (95 % CI: 0.92–0.97), and 0.95 (95 % CI: 0.93–0.97), respectively. The pooled sensitivity of DECT for detecting BME in knee, hip, and ankle joint injuries was 0.80, 0.84, and 0.80, with no significant difference among these joints (P = 0.55). The pooled specificity for knee, hip, and ankle injuries was 0.95, 0.97, and 0.89. Specificity differed significantly among the joints (P < 0.01), with the highest specificity in hip injuries. ConclusionsOur meta-analysis indicates that DECT demonstrates high diagnostic performance in detecting BME in patients with lower limb joint injuries, with the highest specificity observed in hip joint injuries. To validate these findings, further larger prospective studies are necessary.