title: Percent slope analysis of dynamic magnetic resonance imaging for assessment of chemotherapy response of osteosarcoma or Ewing sarcoma: systematic review and meta-analysis.
abstract: OBJECTIVE
  The objective of this systematic review is to provide an up-to-date and unprecedented summary of percent slope analysis of dynamic magnetic resonance imaging (MRI) for the preoperative evaluation of the chemotherapy response of osteosarcoma or Ewing sarcoma.
  
  
  METHODS
  Studies evaluating dynamic MRI for the preoperative evaluation of the chemotherapy response of osteosarcoma or Ewing sarcoma were systematically searched for in MEDLINE, EMBASE, and Web of Science. More than 60 % reduction of the slope of the time intensity curve derived from dynamic MRI was defined as a positive response. Pooled sensitivity and specificity for each study were calculated into 2 × 2 contingency tables. The DerSimonian-Laird random-effects method was used for determining the pooled diagnostic odds ratio and the area under curve (AUC) of the summary receiver operating characteristic (SROC) curve.
  
  
  RESULTS
  A total of six studies with 66 patients who fulfilled all of the inclusion criteria were considered for the meta-analysis. The pooled sensitivity and specificity were 0.73 (95 % CI, 0.54-0.88) and 0.83 (95 % CI, 0.67-0.94), respectively. A significant difference was found between the good and poor responders in the diagnostic odds ratio. The SROC curve showed that the AUC was 0.839, indicating diagnostic accuracy in estimating good therapy response.
  
  
  CONCLUSIONS
  The slope of the time intensity curve derived from dynamic MRI was useful for evaluating the histological response of patients to neoadjuvant chemotherapy in osteosarcoma or Ewing sarcoma.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. kubot@hiroshima-u.ac.jp.
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Furuta
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Muhammad P
authors.initials: MP
authors.lastname: Johan
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Adachi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D020360:Neoadjuvant Therapy; D012516:Osteosarcoma / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D012680:Sensitivity and Specificity
keywords: Chemotherapy response; Dynamic magnetic resonance imaging; Ewing sarcoma; MRI; Meta-analysis; Osteosarcoma