Technical performance of dual-energy CT in the evaluation of hypovascular liver metastases: A systematic review and meta-analysis.
[INTRODUCTION] This systematic review and meta-analysis evaluated the technical performance of dual-energy CT (DECT) in improving contrast resolution for hypovascular liver metastases.
- p-value p < 0.001
- 95% CI 107-221
- 연구 설계 systematic review
APA
Asmundo L, Monti CB, et al. (2026). Technical performance of dual-energy CT in the evaluation of hypovascular liver metastases: A systematic review and meta-analysis.. Radiography (London, England : 1995), 32(1), 103259. https://doi.org/10.1016/j.radi.2025.103259
MLA
Asmundo L, et al.. "Technical performance of dual-energy CT in the evaluation of hypovascular liver metastases: A systematic review and meta-analysis.." Radiography (London, England : 1995), vol. 32, no. 1, 2026, pp. 103259.
PMID
41349167
Abstract
[INTRODUCTION] This systematic review and meta-analysis evaluated the technical performance of dual-energy CT (DECT) in improving contrast resolution for hypovascular liver metastases.
[METHODS] A comprehensive literature search of MEDLINE and EMBASE was conducted from November 2024 to January 2025. Eligible studies assessed DECT for identifying hypovascular liver metastases and reported quantitative DECT metrics, including differences in Hounsfield units (ΔHU), contrast-to-noise ratio (CNR), or signal-to-noise ratio (SNR). A random-effects meta-analysis was performed to pool ΔHU, CNR, and SNR values derived from 40-keV virtual monoenergetic images and to compare them with reference single-energy CT (SECT) data.
[RESULTS] Out of 207 identified records, 12 studies met the inclusion criteria, encompassing a total of 698 patients. The pooled liver ΔHU in DECT was 164 ΔHU (95%CI 107-221 HU, p < 0.001, I = 80 %), significantly higher than values found in literature for SECT. Pooled CNR was 5.53 (95 % CI 4.12-6.95, p < 0.001, I = 72 %), comparable to that of SECT, while the pooled SNR was 9.71 (95 % CI 3.62-15.80, p = 0.002, I = 72 %), slightly lower than SECT.
[CONCLUSION] Compared with SECT, DECT has not demonstrated consistent technical superiority for imaging hypovascular liver metastases. Standardized acquisition protocols are needed to minimize heterogeneity and improve reproducibility.
[IMPLICATIONS FOR PRACTICE] Although DECT provides advanced post-processing options and potential for contrast dose reduction, it may entail radiation doses comparable to or slightly higher than SECT depending on the scanner platform and acquisition protocol. Its use in routine assessment of hypovascular liver metastases remains limited, underscoring the need for standardized protocols, consistent reporting, and combined evaluation of both technical and diagnostic performance to define its clinical value.
[METHODS] A comprehensive literature search of MEDLINE and EMBASE was conducted from November 2024 to January 2025. Eligible studies assessed DECT for identifying hypovascular liver metastases and reported quantitative DECT metrics, including differences in Hounsfield units (ΔHU), contrast-to-noise ratio (CNR), or signal-to-noise ratio (SNR). A random-effects meta-analysis was performed to pool ΔHU, CNR, and SNR values derived from 40-keV virtual monoenergetic images and to compare them with reference single-energy CT (SECT) data.
[RESULTS] Out of 207 identified records, 12 studies met the inclusion criteria, encompassing a total of 698 patients. The pooled liver ΔHU in DECT was 164 ΔHU (95%CI 107-221 HU, p < 0.001, I = 80 %), significantly higher than values found in literature for SECT. Pooled CNR was 5.53 (95 % CI 4.12-6.95, p < 0.001, I = 72 %), comparable to that of SECT, while the pooled SNR was 9.71 (95 % CI 3.62-15.80, p = 0.002, I = 72 %), slightly lower than SECT.
[CONCLUSION] Compared with SECT, DECT has not demonstrated consistent technical superiority for imaging hypovascular liver metastases. Standardized acquisition protocols are needed to minimize heterogeneity and improve reproducibility.
[IMPLICATIONS FOR PRACTICE] Although DECT provides advanced post-processing options and potential for contrast dose reduction, it may entail radiation doses comparable to or slightly higher than SECT depending on the scanner platform and acquisition protocol. Its use in routine assessment of hypovascular liver metastases remains limited, underscoring the need for standardized protocols, consistent reporting, and combined evaluation of both technical and diagnostic performance to define its clinical value.
MeSH Terms
Humans; Liver Neoplasms; Tomography, X-Ray Computed; Radiography, Dual-Energy Scanned Projection; Signal-To-Noise Ratio; Liver