Gu Xindong, He Xining, Wang Hualong, Li Jianhua, Chen Ruwei, Liu Hongen
From the Departments of Neurosurgery.
Radiology, Binzhou People's Hospital, Binzhou, China.
J Comput Assist Tomogr. 2024;48(2):303-310. doi: 10.1097/RCT.0000000000001543. Epub 2023 Oct 25.
In glioma patients that have undergone surgical tumor resection, the ability to reliably distinguish between pseudoprogression (PsP) and a recurrent tumor (RT) is of key clinical importance. Accordingly, this meta-analysis evaluated the utility of dynamic susceptibility contrast-enhanced perfusion-weighted imaging as a means of distinguishing between PsP and RT when analyzing patients with high-grade glioma.
The PubMed, Web of Science, and Wanfang databases were searched for relevant studies. Pooled analyses of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) values were conducted, after which the area under the curve (AUC) for summary receiver operating characteristic curves was computed.
This meta-analysis ultimately included 21 studies enrolling 879 patients with 888 lesions. Cerebral blood volume-associated diagnostic results were reported in 20 of the analyzed studies, and the respective pooled sensitivity, specificity, PLR, and NLR values were 86% (95% confidence interval [CI], 0.81-0.89), 83% (95% CI, 0.77-0.87), 4.94 (95% CI, 3.61-6.75), and 0.18 (95% CI, 0.13-0.23) for these 20 studies. The corresponding AUC value was 0.91 (95% CI, 0.88-0.93), and the publication bias risk was low ( P = 0.976). Cerebral blood flow-related diagnostic results were additionally reported in 6 of the analyzed studies, with respective pooled sensitivity, specificity, PLR, and NLR values of 85% (95% CI, 0.78-0.90), 85% (95% CI, 0.76-0.91), 5.54 (95% CI, 3.40-9.01), and 0.18 (95% CI, 0.12-0.26). The corresponding AUC value was 0.92 (95% CI, 0.89-0.94), and the publication bias risk was low ( P = 0.373).
The present meta-analysis results suggest that dynamic susceptibility contrast-enhanced perfusion-weighted imaging represents an effective diagnostic approach to distinguishing between PsP and RT in high-grade glioma patients.
在接受肿瘤手术切除的胶质瘤患者中，可靠区分假性进展（PsP）和肿瘤复发（RT）的能力具有关键的临床意义。因此，本荟萃分析评估了动态磁敏感对比增强灌注加权成像在分析高级别胶质瘤患者时区分PsP和RT的效用。
检索PubMed、Web of Science和万方数据库中的相关研究。对敏感性、特异性、阳性似然比（PLR）和阴性似然比（NLR）值进行汇总分析，然后计算汇总受试者工作特征曲线的曲线下面积（AUC）。
本荟萃分析最终纳入21项研究，涉及879例患者的888个病灶。20项分析研究报告了脑血容量相关的诊断结果，这20项研究的汇总敏感性、特异性、PLR和NLR值分别为86%（95%置信区间[CI]，0.81 - 0.89）、83%（95%CI，0.77 - 0.87）、4.94（95%CI，3.61 - 6.75）和0.18（95%CI，0.13 - 0.23）。相应的AUC值为0.91（95%CI，0.88 - 0.93），发表偏倚风险较低（P = 0.976）。另外6项分析研究报告了脑血流量相关的诊断结果，其汇总敏感性、特异性、PLR和NLR值分别为85%（95%CI，0.78 - 0.90）、85%（95%CI，0.76 - 0.91）、5.54（95%CI，3.40 - 9.01）和0.18（95%CI，0.12 - 0.26）。相应的AUC值为0.92（95%CI，0.89 - 0.94），发表偏倚风险较低（P = 0.373）。
本荟萃分析结果表明，动态磁敏感对比增强灌注加权成像代表了一种区分高级别胶质瘤患者PsP和RT的有效诊断方法。
