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European Radiology
Erschienen in: European Radiology 9/2018

04.04.2018 | Neuro

Perfusion MRI as a diagnostic biomarker for differentiating glioma from brain metastasis: a systematic review and meta-analysis

verfasst von: Chong Hyun Suh, Ho Sung Kim, Seung Chai Jung, Choong Gon Choi, Sang Joon Kim

Erschienen in: European Radiology | Ausgabe 9/2018

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Abstract

Objectives

Differentiation of glioma from brain metastasis is clinically crucial because it affects the clinical outcome of patients and alters patient management. Here, we present a systematic review and meta-analysis of the currently available data on perfusion magnetic resonance imaging (MRI) for differentiating glioma from brain metastasis, assessing MRI protocols and parameters.

Methods

A computerised search of Ovid-MEDLINE and EMBASE databases was performed up to 3 October 2017, to find studies on the diagnostic performance of perfusion MRI for differentiating glioma from brain metastasis. Pooled summary estimates of sensitivity and specificity were obtained using hierarchical logistic regression modelling. We conducted meta-regression and subgroup analyses to explain the effects of the study heterogeneity.

Results

Eighteen studies with 900 patients were included. The pooled sensitivity and specificity were 90% (95% CI, 84–94%) and 91% (95% CI, 84–95%), respectively. The area under the hierarchical summary receiver operating characteristic curve was 0.96 (95% CI, 0.94–0.98). The meta-regression showed that the percentage of glioma in the study population and the study design were significant factors affecting study heterogeneity. In a subgroup analysis including patients with glioblastoma only, the pooled sensitivity was 92% (95% CI, 84–97%) and the pooled specificity was 94% (95% CI, 85–98%).

Conclusions

Although various perfusion MRI techniques were used, the current evidence supports the use of perfusion MRI to differentiate glioma from brain metastasis. In particular, perfusion MRI showed excellent diagnostic performance for differentiating glioblastoma from brain metastasis.

Key Points

• Perfusion MRI shows high diagnostic performance for differentiating glioma from brain metastasis.
• The pooled sensitivity was 90% and pooled specificity was 91%.
• Peritumoral rCBV derived from DSC is a relatively well-validated.
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Metadaten
Titel
Perfusion MRI as a diagnostic biomarker for differentiating glioma from brain metastasis: a systematic review and meta-analysis
verfasst von
Chong Hyun Suh
Ho Sung Kim
Seung Chai Jung
Choong Gon Choi
Sang Joon Kim
Publikationsdatum
04.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 9/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5335-0

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