Dual-energy CT performance in acute pulmonary embolism: a meta-analysis

source extracted confidence: high 2026-04-09
#humans #pulmonary-embolism #radiography-dual-energy-scanned-projection #reproducibility-of-results #sensitivity-and-specificity

Dual-energy CT performance in acute pulmonary embolism: a meta-analysis

Monti et al., 2021 | Eur Radiol | Meta Analysis

Citation

Monti Caterina B, Zanardo Moreno, ... Sardanelli Francesco. Dual-energy CT performance in acute pulmonary embolism: a meta-analysis. Eur Radiol. 2021-Aug;31(8):6248-6258. doi:10.1007/s00330-020-07633-8

Abstract

OBJECTIVES: To evaluate the diagnostic performance of dual-energy computed tomography (DECT) with regard to its post-processing techniques, namely linear blending (LB), iodine maps (IM), and virtual monoenergetic (VM) reconstructions, in diagnosing acute pulmonary embolism (PE). METHODS: This meta-analysis was conducted according to PRISMA. A systematic search on MEDLINE and EMBASE was performed in December 2019, looking for articles reporting the diagnostic performance of DECT on a per-patient level. Diagnostic performance meta-analyses were conducted grouping study parts according to DECT post-processing methods. Correlations between radiation or contrast dose and publication year were appraised. RESULTS: Seventeen studies entered the analysis. Only lobar and segmental acute PE were considered, subsegmental acute PE being excluded from analysis due to data heterogeneity or lack of data. LB alone was assessed in 6 study parts accounting for 348 patients, showing a pooled sensitivity of 0.87 and pooled specificity of 0.93. LB and IM together were assessed in 14 study parts accounting for 1007 patients, with a pooled sensitivity of 0.89 and pooled specificity of 0.90. LB, IM, and VM together were assessed in 2 studies (for a total 144 patients) and showed a pooled sensitivity of 0.90 and pooled specificity of 0.90. The area under the curve for LB alone, and LB together with IM was 0.93 (not available for studies using LB, IM and VM because of paucity of data). Radiation and contrast dose did not decrease with increasing year of publication. CONCLUSIONS: Considering the published performance of single-energy CT in diagnosing acute PE, either dual-energy or single-energy computed tomography can be comparably used for the detection of acute PE. KEY POINTS: • Dual-energy CT displayed pooled sensitivity and specificity of 0.87 and 0.93 for linear blending alone, 0.89 and 0.90 for linear blending and iodine maps, and 0.90 and 0.90 for linear blending iodine maps, and virtual monoenergetic reconstructions. • The performance of dual-energy CT for patient management is not superior to that reported in literature for single-energy CT (0.83 sensitivity and 0.96 specificity). • Dual-energy CT did not yield substantial advantages in the identification of patients with acute pulmonary embolism compared to single-energy techniques.

Key Findings

Seventeen studies entered the analysis. Only lobar and segmental acute PE were considered, subsegmental acute PE being excluded from analysis due to data heterogeneity or lack of data. LB alone was assessed in 6 study parts accounting for 348 patients, showing a pooled sensitivity of 0.87 and pooled specificity of 0.93. LB and IM together were assessed in 14 study parts accounting for 1007 patients, with a pooled sensitivity of 0.89 and pooled specificity of 0.90. LB, IM, and VM together were as

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population acute pulmonary embolism compared
Sample Size 348
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Pulmonary Embolism
  • Radiography, Dual-Energy Scanned Projection
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09