Dual-Energy Computed Tomography in Spine Fractures: A Systematic Review and Meta-Analysis
Henrik C. Bäcker, Chia H. Wu, Carsten Perka, Gergely Pánics
Abstract
BACKGROUND: The purpose of this study was to perform a systematic literature review and meta-analysis to evaluate the sensitivity, specificity, and accuracy of dual-energy computed tomography (DE-CT) of bone marrow edema and disc edema in spine injuries.In vertebral injuries, prompt diagnosis is essential to avoid any delays in treatment. Conventional radiography may only reveal indirect signs of fractures, such as when it is displaced. Therefore, to detect the presence of bone marrow or disc edemas, adjunctive tools are required, such as magnetic resonance imaging (MRI) or DE-CT. METHODS: Search terms included ((DECT) OR (DE-CT) OR (dual-energy CT) OR "Dual energy CT" OR (dual-energy computed tomography) OR (dual energy computed tomography)) AND ((spine) OR (vertebral)), and the PubMed, EMBASE, and MEDLINE databases and the Cochrane Library and Google were used. We found 1233 articles on our preliminary search, but only 13 articles met all criteria. Data were extracted to calculate the pooled sensitivity, specificity, and diagnostic odds ratio for analysis using R software. RESULTS: = .023). However, significant interobserver differences were reported. CONCLUSIONS: DE-CT seems to be a promising diagnostic tool to detect bone marrow and disc edemas, which can potentially replace the current gold standard, the MRI. LEVEL OF EVIDENCE: 2. CLINICAL RELEVANCE: This study shows that DE-CT seems to be a promising diagnostic tool with an accuracy of 89.3%.