Department of Radiology, The Affil1iated Chengdu 363 Hospita1 of Southwest Medical University, Chengdu, China.
Department of Gynaecology and Obstetrics, The Public Health Clinical Center of Chengdu, Chengdu, China.
Ann Palliat Med. 2021 Dec;10(12):12488-12497. doi: 10.21037/apm-21-3319.
At present, the use of arterial spin-labeling (ASL) imaging to assess the recurrence of gliomas and post-treatment radiation effect (PTRE) is limited, and the results of studies on ASL are quite different. To date, no multi-center, large-scale studies have been conducted to confirm its diagnostic efficacy. This study sought to systematically evaluate the diagnostic value of ASL imaging in distinguishing between glioma recurrence and PTRE.
Databases, including Medline, Cochrane Library, Pub Med, Web of Science, Embase, China National Knowledge Infrastructure, Wan Fang, were searched to retrieve studies that used ASL imaging to diagnose glioma recurrence and radiation-induced brain injury. The search deadline was August 31, 2021. Two reviewers independently screened the literature according to set literature inclusion and exclusion criteria, extracted basic data from the literature, and evaluated the quality of the literature. Revman 5.3 software was used to analyze the included research data.
Ten studies, comprising 216 patients with glioma recurrence and 152 patients with PTRE, were included in the meta-analysis. The results showed that cerebral blood flow [mean difference (MD) =1.67, 95% confidence interval (CI): 0.89-2.46, P=0.000], relative cerebral blood flow (MD =1.20, 95% CI: 0.91-1.49, P=0.000), and relative cerebral blood volume (MD =1.29, 95% CI: 0.98-1.59, P=0.000); this 3 indicators between glioma recurrence and PTRE were significantly different.
ASL imaging has high diagnostic value in distinguishing between glioma recurrence and PTRE.
目前，动脉自旋标记（ASL）成像在评估脑胶质瘤复发和治疗后放射性效应（PTRE）方面的应用受到限制，并且关于 ASL 的研究结果差异很大。迄今为止，尚未开展多中心、大规模的研究来证实其诊断效能。本研究旨在系统评估 ASL 成像在鉴别脑胶质瘤复发与 PTRE 方面的诊断价值。
检索 Medline、Cochrane 图书馆、PubMed、Web of Science、Embase、中国知网、万方等数据库，检索时间截至 2021 年 8 月 31 日，收集使用 ASL 成像诊断脑胶质瘤复发和放射性脑损伤的研究。由 2 位评价员按照设定的文献纳入与排除标准独立筛选文献、提取文献基本数据、评价文献质量后，采用 Revman 5.3 软件进行数据分析。
纳入 10 项研究，共计 216 例脑胶质瘤复发患者和 152 例 PTRE 患者。Meta 分析结果显示，脑血流量[均数差（MD）=1.67，95%置信区间（CI）：0.89-2.46，P=0.000]、相对脑血流量（MD=1.20，95%CI：0.91-1.49，P=0.000）和相对脑血容量（MD=1.29，95%CI：0.98-1.59，P=0.000）这 3 项指标在脑胶质瘤复发与 PTRE 之间差异有统计学意义。
ASL 成像在鉴别脑胶质瘤复发与 PTRE 方面具有较高的诊断价值。
