The Potential of Ultrasound Radiomics in Carpal Tunnel Syndrome Diagnosis: A Systematic Review and Meta-Analysis

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy for which ultrasound imaging has recently emerged as a valuable diagnostic tool. This meta-analysis aims to investigate the role of ultrasound radiomics in the diagnosis of CTS and compare it with other diagnostic approaches. Methods: We conducted a comprehensive search of electronic databases from inception to September 2023. The included studies were assessed for quality using the Quality Assessment Tool for Diagnostic Accuracy Studies. The primary outcome was the diagnostic performance of ultrasound radiomics compared to radiologist evaluation for diagnosing CTS. Results: Our meta-analysis included five observational studies comprising 840 participants. In the context of radiologist evaluation, the combined statistics for sensitivity, specificity, and diagnostic odds ratio were 0.78 (95% confidence interval (CI), 0.71 to 0.83), 0.72 (95% CI, 0.59 to 0.81), and 9 (95% CI, 5 to 15), respectively. In contrast, the ultrasound radiomics training mode yielded a combined sensitivity of 0.88 (95% CI, 0.85 to 0.91), a specificity of 0.88 (95% CI, 0.84 to 0.92), and a diagnostic odds ratio of 58 (95% CI, 38 to 87). Similarly, the ultrasound radiomics testing mode demonstrated an aggregated sensitivity of 0.85 (95% CI, 0.78 to 0.89), a specificity of 0.80 (95% CI, 0.73 to 0.85), and a diagnostic odds ratio of 22 (95% CI, 12 to 41). Conclusions: In contrast to assessments by radiologists, ultrasound radiomics exhibited superior diagnostic performance in detecting CTS. Furthermore, there was minimal variability in the diagnostic accuracy between the training and testing sets of ultrasound radiomics, highlighting its potential as a robust diagnostic tool in CTS.