Diagnostic accuracy of magnetic resonance imaging techniques for treatment response evaluation in patients with high-grade glioma, a systematic review and meta-analysis.
OBJECTIVE
Treatment response assessment in high-grade gliomas uses contrast enhanced T1-weighted MRI, but is unreliable. Novel advanced MRI techniques have been studied, but the accuracy is not well known. Therefore, we performed a systematic meta-analysis to assess the diagnostic accuracy of anatomical and advanced MRI for treatment response in high-grade gliomas.


METHODS
Databases were searched systematically. Study selection and data extraction were done by two authors independently. Meta-analysis was performed using a bivariate random effects model when ≥5 studies were included.


RESULTS
Anatomical MRI (five studies, 166 patients) showed a pooled sensitivity and specificity of 68% (95%CI 51-81) and 77% (45-93), respectively. Pooled apparent diffusion coefficients (seven studies, 204 patients) demonstrated a sensitivity of 71% (60-80) and specificity of 87% (77-93). DSC-perfusion (18 studies, 708 patients) sensitivity was 87% (82-91) with a specificity of 86% (77-91). DCE-perfusion (five studies, 207 patients) sensitivity was 92% (73-98) and specificity was 85% (76-92). The sensitivity of spectroscopy (nine studies, 203 patients) was 91% (79-97) and specificity was 95% (65-99).


CONCLUSIONS
Advanced techniques showed higher diagnostic accuracy than anatomical MRI, the highest for spectroscopy, supporting the use in treatment response assessment in high-grade gliomas.


CONCLUSIONS
• Treatment response assessment in high-grade gliomas with anatomical MRI is unreliable • Novel advanced MRI techniques have been studied, but diagnostic accuracy is unknown • Meta-analysis demonstrates that advanced MRI showed higher diagnostic accuracy than anatomical MRI • Highest diagnostic accuracy for spectroscopy and perfusion MRI • Supports the incorporation of advanced MRI in high-grade glioma treatment response assessment.
University Medical Center Groningen Department of Radiology, University of Groningen, Hanzeplein 1, P. O. Box 30.001, 9700 RB, Groningen, The Netherlands.
Bart R J
BRJ
van Dijken
University Medical Center Groningen Department of Radiology, University of Groningen, Hanzeplein 1, P. O. Box 30.001, 9700 RB, Groningen, The Netherlands.|University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen, The Netherlands.
Peter Jan
PJ
van Laar
University Medical Center Groningen, Department of General Practice, University of Groningen, Groningen, The Netherlands.
Gea A
GA
Holtman
University Medical Center Groningen Department of Radiology, University of Groningen, Hanzeplein 1, P. O. Box 30.001, 9700 RB, Groningen, The Netherlands. a.van.der.hoorn@umcg.nl.|University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen, The Netherlands. a.van.der.hoorn@umcg.nl.
Anouk
A
van der Hoorn
D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D038524:Diffusion Magnetic Resonance Imaging; D005910:Glioma / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D012680:Sensitivity and Specificity
Glioma; Magnetic resonance imaging; Magnetic resonance spectroscopy; Meta-analysis; Treatment response