Diagnostic accuracy of dual-energy computed tomography in bone marrow edema with vertebral compression fractures: A meta-analysis

Purpose: This meta-analysis aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) for the bone marrow edema (BME) in patients with vertebral compression fractures. Methods: The PubMed, EMBASE, and the Cochrane Library database were searched up to July 2017 for relevant original studies. Data were extracted to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR and NLR), and areas under summary receiver operating characteristic (SROC) curves for analysis. Results: A total of seven studies including 510 vertebras were available for the meta-analysis. Overall pooled sensitivity and specificity of DECT for detecting BME were 0.82 (95% CI: 0.76-0.86) and 0.98 (95% CI: 0.97-0.99), respectively. The PLR was 29.74 (95% CI: 15.62-56.61), the NLR was 0.19 (95% CI: 0.11-0.33), and DOR was 201.96 (95% CI: 99.98-407.93). The SROC value was 0.978. In addition, a subgroup analysis was conducted according to the mean time interval between the DECT and MRI. In 5 studies with more than 2 days interval, the pooled sensitivity and specificity of DECT were 0.89 (95% CI: 0.84-0.93) and 0.98 (95% CI: 0.95-0.99), respectively. The AUC value was 0.979. Conclusions: Current evidence of our meta-analysis indicates that DECT has a high diagnostic accuracy in BME of vertebral compression fractures. In addition, DECT may have a less sensitive in BME of hyper-acute period.