Padova Neuroscience Center (PNC), University of Padova, Padova, Italy; Neuroradiology Unit, Padova University Hospital, Padova, Italy.
Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.
Crit Rev Oncol Hematol. 2024 Oct;202:104445. doi: 10.1016/j.critrevonc.2024.104445. Epub 2024 Jul 9.
In high-grade gliomas, pseudoprogression after radiation treatment might dramatically impact patient's management. We searched for perioperative imaging predictors of pseudoprogression in high-grade gliomas according to PRISMA guidelines, using MEDLINE/Pubmed and Embase (until January 2024). Study design, sample size, setting, diagnostic gold standard, imaging modalities and contrasts, and differences among variables or measures of diagnostic accuracy were recorded. Study quality was assessed through the QUADAS-2 tool. Twelve studies (11 with MRI, one with PET; 1058 patients) were reviewed. Most studies used a retrospective design (9/12), and structural MRI (7/12). Studies were heterogeneous in metrics and diagnostic reference standards; patient selection bias was a frequent concern. Pseudoprogression and progression showed some significant group differences in perioperative imaging metrics, although often with substantial overlap. Radiomics showed moderate accuracy but requires further validation. Current literature is scarce and limited by methodological concerns, highlighting the need of new predictors and multiparametric approaches.
在高级别胶质瘤中，放射治疗后的假性进展可能会对患者的治疗管理产生重大影响。我们按照 PRISMA 指南，使用 MEDLINE/Pubmed 和 Embase（截至 2024 年 1 月）搜索了高级别胶质瘤中与假性进展相关的围手术期影像学预测因素。记录了研究设计、样本量、设置、诊断金标准、成像方式和对比剂，以及诊断准确性的变量或测量值之间的差异。使用 QUADAS-2 工具评估了研究质量。共回顾了 12 项研究（11 项 MRI 研究，1 项 PET 研究；1058 名患者）。大多数研究采用回顾性设计（9/12），并使用结构 MRI（7/12）。研究在指标和诊断参考标准上存在异质性；患者选择偏倚是一个常见的问题。尽管假性进展和进展在围手术期影像学指标上存在一些显著的组间差异，但通常存在较大的重叠。放射组学显示出中等准确性，但需要进一步验证。现有文献较少，受到方法学问题的限制，这突出表明需要新的预测因素和多参数方法。
