Effectiveness and radiation dose of computerized tomography virtual hystrosalpingiography in the evaluation of female infertility: Systematic review and meta-analysis

Abstract

Abstract Objective: To build evidence about the effectiveness of computerized tomography virtual hystrosalpingiography (CT-VHSG) in the evaluation of female infertility and to assess the estimated radiation dose imposed. Methods: A systematic review method was utilized to evaluate relevant diagnostic studies. Electronic database was searched from July to October 2017. Hand search was also conducted when applicable. Study quality was assessed according to standardized criteria. Heterogeneity was assessed using subjective and statistical measures. Meta-analysis was judged appropriate and conducted using Open met-analyst software utilizing the random effect model. Results: Based on the assessment of risk of bias of the eligible studies, five studies were included in the final review. Random effects models showed that CT-VHSG has high diagnostic performance (pooled sensitivity 0.992 and specificity 0.98, with negative and positive likelihood ratios of 14.671 and 0.04 respectively). CT-VHSG had comparatively lesser radiation dose than conventional HSG (poled mean effective dose 4.14 mSV vs 6 mSV respectively). Conclusion: CT-VHSG is a reliable procedure with high diagnostic performance in evaluation of the female reproductive tract. CT-VHSG can be regarded as generally safe imaging diagnostic technique in the infertility workup.  In contrary to common belief, CT-VHSG has comparable or lower radiation dose than conventional HSG. Keywords: Female; infertility; tomography; X-ray computed; hysterosalpingography. Continuous...