From the Radiology Department, Binzhou People's Hospital, Binzhou.
Radiology Department, Xuzhou Central Hospital, Xuzhou, China.
J Comput Assist Tomogr. 2022;46(6):938-944. doi: 10.1097/RCT.0000000000001356. Epub 2022 Aug 16.
It is important to differentiate between radiation injury (RI) and tumor recurrence (TR) in patients with glioma after surgery and radiotherapy. Our objective was to evaluate the use of dynamic susceptibility contrast-enhanced perfusion-weighted imaging to distinguish between TR and RI in patients with glioma.
Relevant studies published until October 2021 were identified in the PubMed, Embase, and Cochrane Library databases. Stata v12.0 and RevMan 5.3 were used for meta-analysis.
In total, the meta-analysis incorporated 13 retrospective studies that included 513 patients with 522 lesions. Among the 522 lesions, 329 lesions were TRs and 193 lesions were RIs. The pooled relative cerebral blood volume value was significantly greater in the TR group ( P < 0.00001) with significant heterogeneity ( I2 = 88%). The pooled sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were 83% (95 confidence interval [CI], 77%-88%), 85% (95 CI, 77%-91%), 5.60 (95 CI, 3.61-8.70), and 0.20 (95% CI, 0.14-0.27), respectively. The heterogeneity of sensitivity ( I2 = 33.18%), specificity ( I2 = 24.01%), PLR ( I2 = 0.00%), and NLR ( I2 = 6.68%) is not significant. The area under the receiver operating characteristic curve was 0.91 (95% CI, 0.88-0.93). The 3.0 T magnetic resonance imaging, high-grade glioma, and Europe/America patient subgroups showed PLR greater than 5 and NLR less than 0.2. There was no significant indication of publication bias in the analysis ( P = 0.496).
It is concluded that dynamic susceptibility contrast-enhanced perfusion-weighted imaging is effective for the diagnostic differentiation between TR and RI in patients with glioma.
区分术后放疗后胶质瘤患者的放射性损伤（RI）和肿瘤复发（TR）非常重要。我们的目的是评估动态磁敏感对比增强灌注加权成像在鉴别胶质瘤患者 TR 和 RI 中的作用。
在 PubMed、Embase 和 Cochrane Library 数据库中检索截至 2021 年 10 月发表的相关研究。使用 Stata v12.0 和 RevMan 5.3 进行荟萃分析。
共有 13 项回顾性研究纳入了 513 例患者的 522 个病灶。在 522 个病灶中，329 个病灶为 TR，193 个病灶为 RI。TR 组的相对脑血容量值明显更高（P<0.00001），且存在显著异质性（I2=88%）。汇总的敏感度、特异度、阳性似然比（PLR）和阴性似然比（NLR）分别为 83%（95%可信区间 [CI]，77%-88%）、85%（95%CI，77%-91%）、5.60（95%CI，3.61-8.70）和 0.20（95%CI，0.14-0.27）。敏感度（I2=33.18%）、特异度（I2=24.01%）、PLR（I2=0.00%）和 NLR（I2=6.68%）的异质性不显著。受试者工作特征曲线下面积为 0.91（95%CI，0.88-0.93）。3.0T 磁共振成像、高级别胶质瘤和欧美患者亚组的 PLR 大于 5，NLR 小于 0.2。分析未发现明显的发表偏倚迹象（P=0.496）。
动态磁敏感对比增强灌注加权成像在鉴别胶质瘤患者的 TR 和 RI 方面具有较好的诊断效果。
