Is using Dual Energy Virtual Enhancing over Non-Contrast CT beneficial in terms of Diagnostic Accuracy of finding Adrenal Adenoma? : A Meta-analysis

Dev Himanshubhai Desai, Arman Duisenbayev, Pankti Maniyar, Maria Eleni Malafi, Dev Andharia, Abhijay B. Shah

2023

Full text Open access: Green Metadata (CSL-JSON)
DOI 10.1101/2023.07.13.23292609
Data confidence 70 medium
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Abstract

Abstract Background The study compared the diagnostic accuracy of Dual Energy Virtual Non-Contrast CT (DEvNCT) to Non-Contrast CT (NCT) for adrenal adenomas. Adrenal nodules on CT scans require precise characterization to differentiate between benign and malignant lesions. CT imaging uses features like low attenuation and contrast enhancement to identify adenomas. However, distinguishing adenomas from non-adenoma lesions can be challenging due to overlapping attenuation levels. DEvNCT, a post-processing technique enabled by dual-energy CT, optimizes adrenal lesion evaluation. The study aimed to compare the diagnostic accuracy of DEvNCT and NCT for adrenal adenomas. Methodology A systematic review and meta-analysis searched relevant literature in PubMed, Google Scholar, and Cochrane Library databases. The analysis included nine randomized controlled trials (RCTs) with 407 patients: three RCTs for NCT vs. Biopsy and six RCTs for DEvNCT vs. NCT. Study quality was assessed using appropriate tools. Result Results revealed DEvNCT had 72% sensitivity, 94% specificity, and 0.878 positive predictive value for adrenal adenoma diagnosis. NCT had 80% sensitivity, 68.1% specificity, and 0.831 positive predictive values. The difference in specificity between DEvNCT and NCT was significant, indicating DEvNCT’s superior ability to identify adenomas accurately. Conclusion The study concluded that DEvNCT exhibited comparable sensitivity but higher specificity than NCT in diagnosing adrenal adenomas. DEvNCT could potentially reduce follow-up imaging, lower costs, and minimize radiation exposure. However, biopsy remains the gold standard for confirming adrenal adenoma diagnosis. Overall, DEvNCT shows promise for improving diagnostic accuracy compared to NCT in diagnosing adrenal adenomas. Further research and clinical validation are needed to confirm these findings.