Evaluation of the diagnostic performance of magnetic resonance spectroscopy in brain tumors: a systematic review and meta-analysis.
OBJECTIVE
The aim of this study was to determine the suitability of magnetic resonance spectroscopy (MRS) for screening brain tumors, based on a systematic review and meta-analysis of published data on the diagnostic performance of MRS.


METHODS
The PubMed and PHMC databases were systematically searched for relevant studies up to December 2013. The sensitivities and specificities of MRS in individual studies were calculated and the pooled diagnostic accuracies, with 95% confidence intervals (CI), were assessed under a fixed-effects model.


RESULTS
Twenty-four studies were included, comprising a total of 1013 participants. Overall, no heterogeneity of diagnostic effects was observed between studies. The pooled sensitivity and specificity of MRS were 80.05% (95% CI = 75.97%-83.59%) and 78.46% (95% CI: 73.40%-82.78%), respectively. The area under the summary receiver operating characteristic curve was 0.78. Stratified meta analysis showed higher sensitivity and specificity in child than adult. CSI had higher sensitivity and SV had higher specificity. Higher sensitivity and specificity were obtained in short TE value.


CONCLUSIONS
Although the qualities of the studies included in the meta-analysis were moderate, current evidence suggests that MRS may be a valuable adjunct to magnetic resonance imaging for diagnosing brain tumors, but requires selection of suitable technique and TE value.
Center of PET/CT-MRI, Cancer Hospital of Harbin Medical University, Harbin, 150081, China.
Wenzhi
W
Wang
Center of PET/CT-MRI, Cancer Hospital of Harbin Medical University, Harbin, 150081, China.
Yumin
Y
Hu
Center of PET/CT-MRI, Cancer Hospital of Harbin Medical University, Harbin, 150081, China.
Peiou
P
Lu
Center of PET/CT-MRI, Cancer Hospital of Harbin Medical University, Harbin, 150081, China.
Yingci
Y
Li
Center of PET/CT-MRI, Cancer Hospital of Harbin Medical University, Harbin, 150081, China.
Yunfu
Y
Chen
Center of PET/CT-MRI, Cancer Hospital of Harbin Medical University, Harbin, 150081, China.
Mohan
M
Tian
Center of PET/CT-MRI, Cancer Hospital of Harbin Medical University, Harbin, 150081, China.
Lijuan
L
Yu
D000328:Adult; D019540:Area Under Curve; D001254:Astrocytoma / Q000175:diagnosis* / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D004806:Ependymoma / Q000175:diagnosis* / Q000473:pathology; D005910:Glioma / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D017599:Neuroectodermal Tumors / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity