Luo Hechuan, He Ling, Cheng Weiqin, Gao Sijie
Department of Radiology, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Br J Radiol. 2021 May 1;94(1121):20201321. doi: 10.1259/bjr.20201321.
This meta-analysis was carried out for assessing the accuracy of intravoxel incoherent motion (IVIM) parameters true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) in differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs).
Literatures concerning IVIM in the grading of brain gliomas published prior to October 20, 2020, searched in the Embase, PubMed, and Cochrane library. Use the quality assessment of diagnostic accuracy studies 2 (QUADAS 2) to evaluate the quality of studies. We estimated the pooled sensitivity, specificity, and the area under the summary ROC (SROC) curve to identification the accuracy of IVIM parameters D, D*, and f evaluation in grading gliomas.
Totally, 6 articles including 252 brain gliomas conform to the inclusion criteria. The pooled sensitivity of parameters D, D*, and f derived from IVIM were 0.85 (95%Cl, 0.76-0.91), 0.78 (95%Cl, 0.71-0.85), and 0.89 (95%Cl, 0.76-0.96), respectively. The pooled specificity were 0.78 (95%Cl, 0.60-0.90), 0.68 (95%Cl, 0.56-0.79), and 0.88 (95%Cl, 0.76-0.94), respectively. Meanwhile, the AUC of SROC curve were 0.89 (95%Cl, 0.86-0.92) , 0.81 (95%Cl, 0.77-0.84), and 0.94 (95%Cl, 0.92-0.96), respectively.
This meta-analysis suggested that IVIM parameters D, D*, and f have moderate or high diagnosis value accuracy in differentiating HGGs from LGGs, and the parameter f has greater sensitivity and specificity. Standardized methodology is warranted to guide the use of this method for clinical decision-making. However, more clinical studies are needed to prove our view.
IVIM parameter f showed greater sensitivity and specificity, as well as excellent performance than parameter D* and D.
进行这项荟萃分析以评估体素内不相干运动（IVIM）参数真扩散系数（D）、伪扩散系数（D*）和灌注分数（f）在区分低级别胶质瘤（LGG）与高级别胶质瘤（HGG）中的准确性。
检索2020年10月20日前在Embase、PubMed和Cochrane图书馆发表的有关IVIM在脑胶质瘤分级中的文献。使用诊断准确性研究质量评估2（QUADAS 2）来评估研究质量。我们估计汇总敏感性、特异性和汇总ROC（SROC）曲线下面积，以确定IVIM参数D、D*和f在胶质瘤分级评估中的准确性。
总共6篇文章，包括252例脑胶质瘤符合纳入标准。IVIM得出的参数D、D*和f的汇总敏感性分别为0.85（95%CI，0.76 - 0.91）、0.78（95%CI，0.71 - 0.85）和0.89（95%CI，0.76 - 0.96）。汇总特异性分别为0.78（95%CI，0.60 - 0.90）、0.68（95%CI，0.56 - 0.79）和0.88（95%CI，0.76 - 0.94）。同时，SROC曲线的AUC分别为0.89（95%CI，0.86 - 0.92）、0.81（95%CI，0.77 - 0.84）和0.94（95%CI，0.92 - 0.96）。
这项荟萃分析表明，IVIM参数D、D*和f在区分HGG与LGG方面具有中等或较高的诊断价值准确性，且参数f具有更高的敏感性和特异性。需要标准化方法来指导该方法用于临床决策。然而，需要更多临床研究来证实我们的观点。
IVIM参数f显示出比参数D*和D更高的敏感性和特异性以及出色的性能。
