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Diagnostic accuracy of dual-energy CT in gout: a systematic review and meta-analysis

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Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

Dual-energy CT (DECT) is being widely used in suspected gout patients in recent years. Many clinicians tend to use DECT instead of aspiration biopsy in the diagnosis of gout, but its accuracy has shown controversial results. In this systematic review and meta-analysis, we sought to evaluate the accuracy of DECT in the diagnosis of gout.

Materials and methods

We performed a systematic review of the literature published in Medline, Embase, PubMed, and Cochrane databases. Studies included are all clinical trials of DECT in the diagnosis of gout. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies-2 (QUADAS-2). We recorded sensitivity and specificity of algorithms and calculated positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odd ratio (DOR), and respective confidence intervals (CI). The summary receiver operating characteristic curve (sROC) was drawn to get the Cochran Q-index and the area under the curve (AUC).

Results

Seven studies were included in this review and showed high homogeneity. The analysis results presented the pooled sensitivity was 88% (95% CI 84–90%) and specificity was 90% (95% CI 85–93%). Then, we figured out that the pooled PLR was 8.48 (95% CI 5.89–12.22) and NLR was 0.10 (95% CI 0.04–0.24) respectively. In addition, Cochran-Q was 0.90 and AUC was 0.9565 in sROC curve.

Conclusions

DECT showed relatively high sensitivity and specificity in the diagnosis of gout. Synthetically considering these DECT abnormalities could improve the diagnostic sensitivity. More rigorous and standardized studies are still needed to support these findings.

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Authors and Affiliations

  1. Department of Acupuncture, China-Japan Friendship Hospital, Beijing, 100029, China

    Zhange Yu

  2. Department of Orthopedic Surgery, China-Japan Friendship Hospital, Beijing, 100029, China

    Tianli Mao, Yaping Xu, Tengqi Li, Fuqiang Gao & Wei Sun

  3. Department of Trauma and Orthopedics, Peking University People’s Hospital, South Xizhimen Street No. 11, Xicheng District, Beijing, 100044, China

    Yanhua Wang

  4. Department of Orthopedics, China-Japan Friendship Institute of Clinical Medicine, Peking Union Medical College, Beijing, 100029, China

    Fuqiang Gao & Wei Sun

Authors
  1. Zhange Yu
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  2. Tianli Mao
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  3. Yaping Xu
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  4. Tengqi Li
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  5. Yanhua Wang
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  6. Fuqiang Gao
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  7. Wei Sun
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Corresponding authors

Correspondence to Fuqiang Gao or Wei Sun.

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The authors declare that they have no competing interests.

Additional information

Zhange Yu, Tianli Mao, Yaping Xu, Tengqi Li, and Yanhua Wang joint first authors.

Elegy: Zhange Yu, MD. had done a major work for this study. Unfortunately, he passed away peacefully on 17 May 2017, and he was only early 30s. We will miss him forever. We believe he will still keep shined in the heaven. God bless him!

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Yu, Z., Mao, T., Xu, Y. et al. Diagnostic accuracy of dual-energy CT in gout: a systematic review and meta-analysis. Skeletal Radiol 47, 1587–1593 (2018). https://doi.org/10.1007/s00256-018-2948-y

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  • DOI: https://doi.org/10.1007/s00256-018-2948-y

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