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
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 eva...
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| description | 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. |
| doi_str_mv | 10.1371/journal.pone.0173430 |
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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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0173430</identifier><identifier>PMID: 28301491</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accuracy ; Adult ; Analysis ; Biology and Life Sciences ; Blood ; Brain cancer ; Brain Neoplasms - diagnostic imaging ; Care and treatment ; Central nervous system ; Central Nervous System Neoplasms - diagnostic imaging ; Diagnosis ; Diagnosis, Differential ; Female ; Gangrene ; Glioma ; Glioma - diagnostic imaging ; Gliomas ; Health aspects ; Humans ; Lymphoma ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medical ethics ; Medicine and Health Sciences ; Meta-analysis ; Metastasis ; Nervous system ; Neurosurgery ; NMR ; Non-Hodgkin's lymphomas ; Nuclear magnetic resonance ; Perfusion ; Perfusion Imaging ; Physical Sciences ; Quality ; Research and Analysis Methods ; Sensitivity ; Sensitivity analysis ; Spectrum analysis ; Spin labeling ; Standardization ; Studies ; Systematic review ; Tumors</subject><ispartof>PloS one, 2017-03, Vol.12 (3), p.e0173430-e0173430</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Xu et al. 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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.</description><subject>Accuracy</subject><subject>Adult</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Brain cancer</subject><subject>Brain Neoplasms - diagnostic imaging</subject><subject>Care and treatment</subject><subject>Central nervous system</subject><subject>Central Nervous System Neoplasms - diagnostic imaging</subject><subject>Diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Gangrene</subject><subject>Glioma</subject><subject>Glioma - diagnostic imaging</subject><subject>Gliomas</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Lymphoma</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xu, Weilin</au><au>Wang, Qun</au><au>Shao, Anwen</au><au>Xu, Bainan</au><au>Zhang, Jianmin</au><au>Sherman, Jonathan H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-03-16</date><risdate>2017</risdate><volume>12</volume><issue>3</issue><spage>e0173430</spage><epage>e0173430</epage><pages>e0173430-e0173430</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28301491</pmid><doi>10.1371/journal.pone.0173430</doi><tpages>e0173430</tpages><orcidid>https://orcid.org/0000-0003-2141-6438</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Accuracy Adult Analysis Biology and Life Sciences Blood Brain cancer Brain Neoplasms - diagnostic imaging Care and treatment Central nervous system Central Nervous System Neoplasms - diagnostic imaging Diagnosis Diagnosis, Differential Female Gangrene Glioma Glioma - diagnostic imaging Gliomas Health aspects Humans Lymphoma Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medical ethics Medicine and Health Sciences Meta-analysis Metastasis Nervous system Neurosurgery NMR Non-Hodgkin's lymphomas Nuclear magnetic resonance Perfusion Perfusion Imaging Physical Sciences Quality Research and Analysis Methods Sensitivity Sensitivity analysis Spectrum analysis Spin labeling Standardization Studies Systematic review Tumors |
| 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 |
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