title: The performance of MR perfusion-weighted imaging for the differentiation of high-grade glioma from primary central nervous system lymphoma: A systematic review and meta-analysis.
abstract: It is always a great challenge to distinguish high-grade glioma (HGG) from primary central nervous system lymphoma (PCNSL). We conducted a meta-analysis to assess the performance of MR perfusion-weighted imaging (PWI) in differentiating HGG from PCNSL. The heterogeneity and threshold effect were evaluated, and the sensitivity (SEN), specificity (SPE) and areas under summary receiver operating characteristic curve (SROC) were calculated. Fourteen studies with a total of 598 participants were included in this meta-analysis. The results indicated that PWI had a high level of accuracy (area under the curve (AUC) = 0.9415) for differentiating HGG from PCNSL by using the best parameter from each study. The dynamic susceptibility-contrast (DSC) technique might be an optimal index for distinguishing HGGs from PCNSLs (AUC = 0.9812). Furthermore, the DSC had the best sensitivity 0.963 (95%CI: 0.924, 0.986), whereas the arterial spin-labeling (ASL) displayed the best specificity 0.896 (95% CI: 0.781, 0.963) among those techniques. However, the variability of the optimal thresholds from the included studies suggests that further evaluation and standardization are needed before the techniques can be extensively clinically used.
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Weilin
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital, Haidian District, Beijing, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Anwen
authors.initials: A
authors.lastname: Shao
authors.affiliation: Department of Neurosurgery, Chinese PLA General Hospital, Haidian District, Beijing, China.
authors.forename: Bainan
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.|Brain Research Institute, Zhejiang University, Hangzhou, Zhejiang, China.|Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Jianmin
authors.identifier: http://orcid.org/0000-0003-2141-6438
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging*; D016543:Central Nervous System Neoplasms / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D055420:Perfusion Imaging