Department of Brain Repair and Rehabilitation, University College London, Institute of Neurology, London, England (S.O., A.H., X.G., M.K., S.T.); Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan (S.O.); and Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, England (S.T.).
Radiol Imaging Cancer. 2020 Jan 31;2(1):e190036. doi: 10.1148/rycan.2020190036. eCollection 2020 Jan.
To generate a narrative synthesis of published data on the use of endogenous chemical exchange saturation transfer (CEST) MRI in brain tumors.
A systematic database search (PubMed, Ovid Embase, Cochrane Library) was used to collate eligible studies. Two researchers independently screened publications according to predefined exclusion and inclusion criteria, followed by comprehensive data extraction. All included studies were subjected to a bias risk assessment using the Quality Assessment of Diagnostic Accuracy Studies tool.
The electronic database search identified 430 studies, of which 36 fulfilled the inclusion criteria. The final selection of included studies was categorized into five groups as follows: grading gliomas, 19 studies (area under the receiver operating characteristic curve [AUC], 0.500-1.000); predicting molecular subtypes of gliomas, five studies (AUC, 0.610-0.920); distinction of different brain tumor types, seven studies (AUC, 0.707-0.905); therapy response assessment, three studies (AUC not given); and differentiating recurrence from treatment-related changes, five studies (AUC, 0.880-0.980). A high bias risk was observed in a substantial proportion of studies.
Endogenous CEST MRI offers valuable, potentially unique information in brain tumors, but its diagnostic accuracy remains incompletely known. Further research is required to assess the method's role in support of molecular genetic diagnosis, to investigate its use in the posttreatment phase, and to compare techniques with a view to standardization. Brain/Brain Stem, MR-Imaging, Neuro-Oncology© RSNA, 2020.
对发表的关于内源性化学交换饱和传递（CEST）MRI 在脑肿瘤中的应用的研究数据进行叙述性综合。
系统地检索数据库（PubMed、Ovid Embase、Cochrane 图书馆），以汇集符合条件的研究。两名研究人员根据预先设定的排除和纳入标准，独立筛选出版物，然后进行全面的数据提取。使用诊断准确性研究质量评估工具对所有纳入的研究进行偏倚风险评估。
电子数据库搜索共确定了 430 项研究，其中 36 项符合纳入标准。最终选择的纳入研究分为以下五组：胶质瘤分级，19 项研究（受试者工作特征曲线下面积 [AUC]，0.500-1.000）；预测胶质瘤的分子亚型，5 项研究（AUC，0.610-0.920）；不同脑肿瘤类型的鉴别，7 项研究（AUC，0.707-0.905）；治疗反应评估，3 项研究（未给出 AUC）；区分复发与治疗相关的变化，5 项研究（AUC，0.880-0.980）。相当一部分研究存在较高的偏倚风险。
内源性 CEST MRI 可为脑肿瘤提供有价值的、潜在独特的信息，但对其诊断准确性的了解仍不完整。需要进一步研究以评估该方法在支持分子遗传学诊断中的作用，研究其在治疗后阶段的应用，并比较各种技术以实现标准化。
脑/脑干，磁共振成像，神经肿瘤学 © RSNA，2020。
