Diagnostic accuracy of dual-energy computed tomography (DECT) to detect non-traumatic bone marrow edema: A systematic review and meta-analysis

•10 studies involving 2463 regions of hand, ankle, hip, sacroiliac joint and so on were evaluated.•More rigorous and comprehensive data extraction and analysis was presented.•DECT shows a excellent diagnostic performance, with the sensitivity, specificity, and AUROC values are 88.4%, 96.1%, and 0.98. This meta-analysis aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) for detecting bone marrow edema (BME) in non-traumatic patients. A systematic search of PubMed, EMBASE, and the Cochrane Library databases was performed up to October 1, 2021 for relevant original studies. Study details were extracted by two independent reviewers. A bivariate mixed-effects regression model was used to assess comprehensive diagnostic performance, and a subgroup analysis was performed to evaluate sources of variability. The risk of bias was evaluated with the QUADAS-2 tool. Ten studies involving 2463 regions, including hands, ankles, hips, and sacroiliac joints, were evaluated in this meta-analysis. Summary sensitivity, specificity, and area under the receiver operating characteristic curve values for BME were 88.4% (95% confidence interval (CI) 82.4%–92.5%), 96.1% (95% CI 94.4%–97.3%), and 0.98 (95% CI 96%–99%), respectively. The subgroup analysis showed that studies using a thicker slice (≥1 mm) had a higher sensitivity, and studies with older patients (≥60 years), fewer included patients (