Diagnostic accuracy of dual-energy computed tomography in patients with gout: A meta-analysis

Objective: This study aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) for patients with gout. Methods: We searched the Medline, Embase, and Cochrane Library databases, and performed a meta analysis on the diagnostic accuracy of DECT in patients with gout. Results: A total of eight studies including 510 patients with gout and 268 controls (patients with non gout inflammatory arthritis) were available for the meta-analysis. The pooled sensitivity and specificity of DECT were 84.7% (95% confidence interval [CI]: 81.3-87.7) and 93.7% (93.0-96.3), respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 9.882 (6.122-15.95), 0.163 (0.097-0.272), and 78.10 (31.14-195.84), respectively. The area under the curve of DECT was 0.956 and the Q(*) index was 0.889, indicating a high diagnostic accuracy. Some between-study heterogeneity was found in the meta-analyses. However, there was no evidence of a threshold effect (Spearman correlation coefficient = 0.419; p = 0.035). In addition, meta-regression showed that the sample size, study design, and diagnostic criteria were not sources of heterogeneity, and subgroup meta-analyses did not change the overall diagnostic accuracy. Conclusions: Our meta-analysis of published studies demonstrates that DECT has a high diagnostic accuracy and plays an important role in the diagnosis of gout. (C) 2017 Elsevier Inc. All rights reserved.