title: Diagnostic accuracy of dual-energy computed tomography in patients with gout: A meta-analysis.
abstract: This study aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) for patients with gout.
  
  
  
  We searched the Medline, Embase, and Cochrane Library databases, and performed a meta-analysis on the diagnostic accuracy of DECT in patients with gout.
  
  
  
  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.
  
  
  
  Our meta-analysis of published studies demonstrates that DECT has a high diagnostic accuracy and plays an important role in the diagnosis of gout.
authors.affiliation: Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine, Seoul, South Korea. Electronic address: lyhcgh@korea.ac.kr.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Gwan Gyu
authors.initials: GG
authors.lastname: Song
mesh_terms: D019540:Area Under Curve; D016022:Case-Control Studies; D004551:Elbow Joint / Q000000981:diagnostic imaging; D033023:Foot Joints / Q000000981:diagnostic imaging; D006073:Gout / Q000000981:diagnostic imaging*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D016017:Odds Ratio; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: DECT; Diagnostic accuracy; Gout; Meta-analysis