Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis

作者：Verburg, N.; Hoefnagels, F. W. A.; Barkhof, F.; Boellaard, R.; Goldman, S.; Guo, J.; Heimans, J. J.; Hoekstra, O. S.; Jain, R.; Kinoshita, M.; Pouwels, P. J. W.; Price, S. J.; Reijneveld, J. C.; Stadlbauer, A.; Vandertop, W. P.; Wesseling, P.; Zwinderman, A. H.; De Witt Hamer, P. C.

来源：American Journal of Neuroradiology, 2017, 38(10): 1884-1891.

DOI：10.3174/ajnr.A5368

• MAGNETIC-RESONANCE-SPECTROSCOPY
• NEUROONCOLOGY WORKING GROUP
• RESPONSE ASSESSMENT
• RADIATION-THERAPY
• GLIOBLASTOMA-MULTIFORME
• SYSTEMATIC REVIEWS
• CLINICAL-TRIALS
• GRADE GLIOMAS
• PET
• CANCER

BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.
PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.
DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.
STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.
DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.
DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and C-11 methionine-PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.
LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.
CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.

• 出版日期2017-10
• 单位复旦大学