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RT Journal Article
SR Electronic
T1 Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A5368
A1 Verburg, N.
A1 Hoefnagels, F.W.A.
A1 Barkhof, F.
A1 Boellaard, R.
A1 Goldman, S.
A1 Guo, J.
A1 Heimans, J.J.
A1 Hoekstra, O.S.
A1 Jain, R.
A1 Kinoshita, M.
A1 Pouwels, P.J.W.
A1 Price, S.J.
A1 Reijneveld, J.C.
A1 Stadlbauer, A.
A1 Vandertop, W.P.
A1 Wesseling, P.
A1 Zwinderman, A.H.
A1 De Witt Hamer, P.C.
YR 2017
UL http://www.ajnr.org/content/early/2017/09/07/ajnr.A5368.abstract
AB BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and 11C methionine–PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.AbbreviationshsROChierarchic summary receiver operating characteristicROCreceiver operating characteristicSTARDStandard for Reporting of Diagnostic AccuracyCIcredibility intervalTPtrue-positiveTNtrue-negativeFPfalse-positiveFNfalse-negative