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PT  - JOURNAL ARTICLE
AU  - Kurokawa, R.
AU  - Baba, A.
AU  - Kurokawa, M.
AU  - Capizzano, A.
AU  - Hassan, O.
AU  - Johnson, T.
AU  - Ota, Y.
AU  - Kim, J.
AU  - Hagiwara, A.
AU  - Moritani, T.
AU  - Srinivasan, A.
TI  - Pretreatment ADC Histogram Analysis as a Prognostic Imaging Biomarker for Patients with Recurrent Glioblastoma Treated with Bevacizumab: A Systematic Review and Meta-analysis
AID  - 10.3174/ajnr.A7406
DP  - 2022 Feb 01
TA  - American Journal of Neuroradiology
PG  - 202--206
VI  - 43
IP  - 2
4099  - http://www.ajnr.org/content/43/2/202.short
4100  - http://www.ajnr.org/content/43/2/202.full
SO  - Am. J. Neuroradiol.2022 Feb 01; 43
AB  - BACKGROUND: The mean ADC value of the lower Gaussian curve (ADCL) derived from the bi-Gaussian curve-fitting histogram analysis has been reported as a predictive/prognostic imaging biomarker in patients with recurrent glioblastoma treated with bevacizumab; however, its systematic summary has been lacking.PURPOSE: We applied a systematic review and meta-analysis to investigate the predictive/prognostic performance of ADCL in patients with recurrent glioblastoma treated with bevacizumab.DATA SOURCES: We performed a literature search using PubMed, Scopus, and EMBASE.STUDY SELECTION: A total of 1344 abstracts were screened, of which 83 articles were considered potentially relevant. Data were finally extracted from 6 studies including 578 patients.DATA ANALYSIS: Forest plots were generated to illustrate the hazard ratios of overall survival and progression-free survival. The heterogeneity across the studies was assessed using the Cochrane Q test and I2 values.DATA SYNTHESIS: The pooled hazard ratios for overall survival and progression-free survival in patients with an ADCL lower than the cutoff values were 1.89 (95% CI, 1.53–2.31) and 1.98 (95% CI, 1.54–2.55) with low heterogeneity among the studies. Subgroup analysis of the bevacizumab-free cohort showed a pooled hazard ratio for overall survival of 1.20 (95% CI, 1.08–1.34) with low heterogeneity.LIMITATIONS: The conclusions are limited by the difference in the definition of recurrence among the included studies.CONCLUSIONS: This systematic review with meta-analysis supports the prognostic value of ADCL in patients with recurrent glioblastoma treated with bevacizumab, with a low ADCL demonstrating decreased overall survival and progression-free survival. On the other hand, the predictive role of ADCL for bevacizumab treatment was not confirmed.ADCLmean ADC value of the lower Gaussian curveHRhazard ratioOSoverall survivalPFSprogression-free survivalQUADAS-2Quality Assessment of Diagnostic Accuracy Studies 2VEGFvascular endothelial growth factor