University Medical Center Groningen Department of Radiology, University of Groningen, Hanzeplein 1, P. O. Box 30.001, 9700 RB, Groningen, The Netherlands.
University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen, The Netherlands.
Eur Radiol. 2017 Oct;27(10):4129-4144. doi: 10.1007/s00330-017-4789-9. Epub 2017 Mar 22.
Treatment 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.
Databases 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.
Anatomical 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).
Advanced techniques showed higher diagnostic accuracy than anatomical MRI, the highest for spectroscopy, supporting the use in treatment response assessment in high-grade gliomas.
• 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.
高级别脑胶质瘤的治疗反应评估采用对比增强 T1 加权 MRI，但不可靠。已研究了新的高级 MRI 技术，但准确性尚不清楚。因此，我们进行了系统的荟萃分析，以评估解剖学和高级 MRI 对高级别脑胶质瘤治疗反应的诊断准确性。
系统地搜索数据库。由两名作者独立进行研究选择和数据提取。当纳入≥5 项研究时，使用双变量随机效应模型进行荟萃分析。
解剖学 MRI（五项研究，166 例患者）显示出 68%（95%CI 51-81）的汇总敏感性和 77%（45-93）的特异性。汇总表观扩散系数（七项研究，204 例患者）显示出 71%（60-80）的敏感性和 87%（77-93）的特异性。DSC 灌注（18 项研究，708 例患者）的敏感性为 87%（82-91），特异性为 86%（77-91）。DCE 灌注（五项研究，207 例患者）的敏感性为 92%（73-98），特异性为 85%（76-92）。波谱学的敏感性（九项研究，203 例患者）为 91%（79-97），特异性为 95%（65-99）。
高级技术的诊断准确性高于解剖学 MRI，其中波谱学的准确性最高，支持其在高级别脑胶质瘤的治疗反应评估中应用。
高级别脑胶质瘤的解剖学 MRI 治疗反应评估不可靠。
已研究了新的高级 MRI 技术，但准确性尚不清楚。
荟萃分析表明，高级 MRI 的诊断准确性高于解剖学 MRI。
波谱学和灌注 MRI 的诊断准确性最高。
支持将高级 MRI 纳入高级别脑胶质瘤的治疗反应评估中。
