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PT  - JOURNAL ARTICLE
AU  - Delgado, A.F.
AU  - De Luca, F.
AU  - Hanagandi, P.
AU  - van Westen, D.
AU  - Delgado, A.F.
TI  - Arterial Spin-Labeling in Children with Brain Tumor: A Meta-Analysis
AID  - 10.3174/ajnr.A5727
DP  - 2018 Aug 01
TA  - American Journal of Neuroradiology
PG  - 1536--1542
VI  - 39
IP  - 8
4099  - http://www.ajnr.org/content/39/8/1536.short
4100  - http://www.ajnr.org/content/39/8/1536.full
SO  - Am. J. Neuroradiol.2018 Aug 01; 39
AB  - BACKGROUND: The value of arterial spin-labeling in a pediatric population has not been assessed in a meta-analysis.PURPOSE: Our aim was to assess the diagnostic accuracy of arterial spin-labeling–derived cerebral blood flow to discriminate low- and high-grade tumors.DATA SOURCES: MEDLINE, EMBASE, the Web of Science Core Collection, and the Cochrane Library were used.STUDY SELECTION: Pediatric patients with arterial spin-labeling MR imaging with verified neuropathologic diagnoses were included.DATA ANALYSIS: Relative CBF and absolute CBF and tumor grade were extracted, including sequence-specific information. Mean differences in CBF between low- and high-grade tumors were calculated. Study quality was assessed.DATA SYNTHESIS: Data were aggregated using the bivariate summary receiver operating characteristic curve model. Heterogeneity was explored with meta-regression and subgroup analyses. The study protocol was published at PROSPERO (CRD42017075055). Eight studies encompassing 286 pediatric patients were included. The mean differences in absolute CBF were 29.62 mL/min/100 g (95% CI, 10.43–48.82 mL/min/100 g), I2 = 74, P = .002, and 1.34 mL/min/100 g (95% CI, 0.95–1.74 mL/min/100 g), P &amp;lt; .001, I2 = 38 for relative CBF. Pooled sensitivity for relative CBF ranged from 0.75 to 0.90, and specificity, from 0.77 to 0.92 with an area under curve = 0.92. Meta-regression showed no moderating effect of sequence parameters TE, TR, acquisition time, or ROI method.LIMITATIONS: Included tumor types, analysis method, and original data varied among included studies.CONCLUSIONS: Arterial spin-labeling–derived CBF measures showed high diagnostic accuracy for discriminating low- and high-grade tumors in pediatric patients with brain tumors. The relative CBF showed less variation among studies than the absolute CBF.aCBFabsolute CBFASLarterial spin-labelingHGThigh-grade tumorLGTlow-grade tumorrCBFrelative CBFQUADAS-2Quality Assessment of Diagnostic Accuracy StudiesWHOWorld Health Organization