title: Diagnostic significance of arterial spin labeling in the assessment of tumor grade in brain.
abstract: BACKGROUND
  The objective of the current meta.analysis was to assess the arterial spin labeling. (ASL) perfusion imaging measurement of cerebral blood flow. (CBF) in patients with brain tumors, and assessing preoperative tumor grade in brain.
  
  
  METHODS
  PubMed, Web of Science, Embase, China BioMedicine (CBM), CINAHL, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases were chosen to evaluate the associations between ASL and brain cancer. Two reviewers separately evaluated the quality of the included trials. Standardized mean difference (SMD) at 95% confidence interval (95% CI) was also calculated.
  
  
  RESULTS
  Finally, 475 patients were enrolled into this meta-analysis from 12 eligible studies and were selected for statistical analysis. Results showed that relative tumor blood flow (rTBF) and relative cerebral blood flow (rCBF) in high-grade brain cancer patients were faster than those in low-grade brain cancer patients. Subgroup analysis stratified by country implied that ASL may be the main prediction of increased rTBF in high-grade brain cancer patients among USA, Korea and China; and rCBF was faster in high-grade brain cancer using ASL in USA and China. Further reference by tissue-stratified analysis revealed a positive association of rTBF with high-grade brain cancer by utilization of ASL in all the experimental subgroups, while rCBF was only correlated in white subgroups.
  
  
  CONCLUSIONS
  These results showed that rTBF and rCBF were faster in high-grade brain cancer patients, suggesting that ASL may provide suitable measurement for the differential diagnosis of tumor grade in brain.
authors.forename: Yu-Fang
authors.initials: YF
authors.lastname: Wang
authors.forename: Bo
authors.initials: B
authors.lastname: Hou
authors.forename: Su-Jun
authors.initials: SJ
authors.lastname: Yang
authors.forename: Xiao-Rui
authors.initials: XR
authors.lastname: Zhang
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Dong
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.affiliation: CT Scan Room, Han Dan Central Hospital, Han Dan, China.
authors.forename: Gen-Dong
authors.initials: GD
authors.lastname: Yao
mesh_terms: D001158:Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002560:Cerebrovascular Circulation; D002681:China; D003287:Contrast Media / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D060787:Neoplasm Grading; D055420:Perfusion Imaging; D056910:Republic of Korea; D013113:Spin Labels; D014481:United States
chemical_list: D003287:Contrast Media; D013113:Spin Labels