A meta-analysis of the diagnostic accuracy of dual-energy computed tomography for endoleak detection after endovascular aneurysm repair.

Cynthia Xin Wen, Shivshankar Thanigaimani, Sonja Brennan, Joseph Moxon, Jonathan Golledge

Abstract readMeta-AnalysisReview

In one paragraph

Synthesis in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

Spectral Computed Tomography Angiography in Visceral Artery Aneurysms: Technical Principles and Clinical Applications.Tomography (Ann Arbor, Mich.) · 2026
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Cynthia Xin WenQueensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Shivshankar ThanigaimaniQueensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Sonja BrennanAustralian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia.

Joseph MoxonQueensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Jonathan GolledgeQueensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia. jonathan.golledge@jcu.edu.au.ORCID http://orcid.org/0000-0002-5779-8848

Funding

Queensland Government and Medical Research Futures Fund 2015999Tropical Australian Academic Health Centre (TAAHC) Research Fund CF001223

6 · The paper itself

Abstract

backgroundPatients who have undergone endovascular repair of an abdominal or thoracic aortic aneurysm (EVAR or TEVAR) are recommended to undergo lifelong imaging surveillance to detect endoleaks. Gold standard imaging is by triphasic single energy computed tomography (SECT), however, dual-energy CT (DECT) can reduce radiation exposure by reducing the number of scan phases required. The accuracy of DECT in detecting endoleaks is uncertain. This review assessed the diagnostic accuracy of DECT for detecting endoleaks and compared radiation exposure to conventional triphasic SECT. METHODS AND

resultsObservational studies from Scopus and PubMed databases were screened up to 12th June 2024. Ten studies reporting the diagnostic accuracy of patients previously treated by EVAR or TEVAR were included. According to the quality assessment tool for diagnostic accuracy studies (QUADAS-2), all included studies were considered to have a high risk of bias. A meta-analysis of these studies involving 803 scans on 744 patients found that the pooled sensitivity, specificity and diagnostic odds ratio (DOR) of the DECT as compared to the triphasic SECT were 94.0% (95% CI: 88.9%, 96.9%), 98.9% (95% CI: 95.7%, 99.7%), and 266.4 (95% CI: 140.9, 503.8), respectively. A radiation dose reduction by 29-62% was achieved with DECT as compared to the triphasic SECT.

conclusionsThis meta-analysis suggests that DECT has similar diagnostic accuracy to triphasic SECT for diagnosing endoleak after endovascular aneurysm repair. This suggests that DECT could be adopted in clinical practice because of the lower radiation dose as compared to the conventional triphasic SECT. KEY POINTS: Question What is the accuracy of dual energy (DE) as compared to triphasic single energy (SE) computed tomography (CT) for diagnosing endoleak after endovascular aneurysm repair? Findings As compared to triphasic SECT, DECT was accurate in diagnosing endoleak after endovascular aneurysm repair and exposed patients to a lower radiation dose. Clinical relevance The radiation dose associated with lifelong follow-up CT scans after endovascular aneurysm repair has been linked to an increased risk of cancer. This study suggests that the use of DECT can reduce radiation exposure without compromising the accuracy of diagnosing endoleak.

Indexed as

Aortic Aneurysm, AbdominalAortic Aneurysm, ThoracicEndoleakEndovascular ProceduresRadiography, Dual-Energy Scanned ProjectionTomography, X-Ray ComputedEndovascular Aneurysm RepairHumansSensitivity and SpecificityDiagnostic accuracyDual energy CTEndovascular repair of aortic aneurysmRadiation dose

Identifiers

PMID40483293

DOI10.1007/s00330-025-11717-8

PMCPMC12634740

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.