Zhao Jiaying, Huang Songtao, Xie Huan, Li Wenfei
Department of Rheumatology and Immunology.
Department of Radiology, Guang'an People's Hospital, Sichuan.
Medicine (Baltimore). 2019 Mar;98(10):e14768. doi: 10.1097/MD.0000000000014768.
To perform a meta-analysis to evaluate the diagnostic accuracy of the amide proton transfer (APT) technique in differentiating high-grade gliomas (HGGs) from low grade gliomas (LGGs).
Medical literature databases were searched for studies that evaluated the diagnostic accuracy of APT in patients suspected of brain tumor who underwent APT MRI and surgery. Only English language studies and published before September 2018 were considered to be included in this project. Homogeneity was assessed by the inconsistency index. Mean difference (MD) at 95% confidence interval (CI) of all parameters derived from APT was calculated. Publication bias was explored by Egger's funnel plot.
Six eligible studies were included in the meta-analysis, comprising 144 HGGs and 122 LGGs. The APT-related parameter signal intensity (SI) was significantly higher in the HGG than the LGG (WMD = 0.86 (0.61-1.1), P < .0001); A significant difference was also found between grade II and grade III (WMD = 0.6 (0.4-0.8), P < .0001), and between grade II and grade IV (WMD = 1.07 (0.65-1.49), P < .0001).
APT imaging may be a useful imaging biomarker for discriminating between LGGs and HGGs. However, large randomized control trials (RCT) were necessary to evaluate its clinical value.
进行一项荟萃分析，以评估酰胺质子转移（APT）技术在鉴别高级别胶质瘤（HGG）与低级别胶质瘤（LGG）中的诊断准确性。
检索医学文献数据库，查找评估接受APT磁共振成像（MRI）和手术的疑似脑肿瘤患者中APT诊断准确性的研究。仅纳入2018年9月之前发表的英文研究。通过不一致指数评估同质性。计算来自APT的所有参数在95%置信区间（CI）的平均差异（MD）。通过Egger漏斗图探讨发表偏倚。
六项符合条件的研究纳入荟萃分析，包括144例HGG和122例LGG。HGG中与APT相关的参数信号强度（SI）显著高于LGG（加权平均差[WMD] = 0.86[0.61 - 1.1]，P <.0001）；在II级和III级之间（WMD = 0.6[0.4 - 0.8]，P <.0001）以及II级和IV级之间（WMD = 1.07[0.65 - 1.49]，P <.0001）也发现了显著差异。
APT成像可能是鉴别LGG和HGG的一种有用的成像生物标志物。然而，需要大型随机对照试验（RCT）来评估其临床价值。
