Diagnostic accuracy of magnetic resonance imaging techniques for treatment response evaluation in patients with high-grade glioma, a systematic review and meta-analysisReportar como inadecuado




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European Radiology

pp 1–16

First Online: 22 March 2017Received: 05 December 2016Revised: 01 February 2017Accepted: 23 February 2017

Abstract

ObjectiveTreatment response assessment in high-grade gliomas uses contrast enhanced T1-weighted MRI, but is unreliable. Novel advanced MRI techniques have been studied, but the accuracy is not well known. Therefore, we performed a systematic meta-analysis to assess the diagnostic accuracy of anatomical and advanced MRI for treatment response in high-grade gliomas.

MethodsDatabases were searched systematically. Study selection and data extraction were done by two authors independently. Meta-analysis was performed using a bivariate random effects model when ≥5 studies were included.

ResultsAnatomical MRI five studies, 166 patients showed a pooled sensitivity and specificity of 68% 95%CI 51–81 and 77% 45–93, respectively. Pooled apparent diffusion coefficients seven studies, 204 patients demonstrated a sensitivity of 71% 60–80 and specificity of 87% 77–93. DSC-perfusion 18 studies, 708 patients sensitivity was 87% 82–91 with a specificity of 86% 77–91. DCE-perfusion five studies, 207 patients sensitivity was 92% 73–98 and specificity was 85% 76–92. The sensitivity of spectroscopy nine studies, 203 patients was 91% 79–97 and specificity was 95% 65–99.

ConclusionAdvanced techniques showed higher diagnostic accuracy than anatomical MRI, the highest for spectroscopy, supporting the use in treatment response assessment in high-grade gliomas.

Key points• Treatment response assessment in high-grade gliomas with anatomical MRI is unreliable

• Novel advanced MRI techniques have been studied, but diagnostic accuracy is unknown

• Meta-analysis demonstrates that advanced MRI showed higher diagnostic accuracy than anatomical MRI

• Highest diagnostic accuracy for spectroscopy and perfusion MRI

• Supports the incorporation of advanced MRI in high-grade glioma treatment response assessment

KeywordsGlioma Magnetic resonance imaging Meta-analysis Magnetic resonance spectroscopy Treatment response AbbreviationsADCApparent diffusion coefficient

ASLArterial spin labelling

CCRTConcomitant chemoradiotherapy

CIConfidence interval

DCEDynamic contrast enhanced

DSCDynamic susceptibility contrast

HGGHigh-grade glioma

MRSMagnetic resonance spectroscopy

PRISMAPreferred reporting items for systematic reviews and meta-analysis

QUADASQuality assessment of diagnostic accuracy studies

RANOResponse assessment in neuro-oncology

rCBVRelative cerebral blood volume

TMZTemozolomide

WHOWorld Health Organisation

Electronic supplementary materialThe online version of this article doi:10.1007-s00330-017-4789-9 contains supplementary material, which is available to authorized users.

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Autor: Bart R. J. van Dijken - Peter Jan van Laar - Gea A. Holtman - Anouk van der Hoorn

Fuente: https://link.springer.com/



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