Introduction
Methods
Search strategy
Quality assessment and data analysis
Results
Search results
References | Study Design | Patient | Exposure | Comparison | Outcome | Reference Standard |
---|---|---|---|---|---|---|
Dequesada 2008 [16] | Retrospective case series | 32 Mets treated with SRS | MRI lesion quotient ≤ 0.3 (retrospective) (blinded review) | AV shunt, enhancement pattern, etc. | Sensitivity: 80% Specificity: 96.4% Accuracy: 94% | Histology for all 32 lesions (blinded review) |
Leeman 2013 [17] | Retrospective case series | 49 Mets 52 lesions treated with SRS | MRI edema/lesion volume ratio ≥ 10 (retrospective) (blinded review) | None | Sensitivity: 84.6% Specificity: 62.9% Accuracy: 69% | Histology obtained by removal in all 52 lesions |
Santra 2011 [18] | Prospective cohort study | 85 gliomas (16 GIVs, 28 GIIIs, 37GIIs, 4 GIs) | MRI Gd-enhancement (blinded review) | 99mTc-GHA-PET (blinded review) | Sensitivity: 24.1% Specificity: 94.6% Accuracy: 71% | 5 Histological and 80 clinical diagnosis (repeat imaging, F/U ≥ 6 mos) |
Tie 2008 [19] | Retrospective case series (consecutive) | 19 gliomas (21 examinations) (7 GBMs, 7 AAs, 5 AOs) | MRI T1, T2, FLAIR, GdT1 Radiological report | 201Tl-SPECT | Sensitivity: 75% Specificity: 64.7% Accuracy: 67% | 9 Histological and 12 clinical diagnosis (clinical course) |
Di Costanzo 2014 [20] | Retrospective case series (consecutive) | 29 GBMs | DWI ADC alone (higher) | Sensitivity: 87.5% Specificity: 81.0% Accuracy: 83% | Clinical diagnosis (≥4 F/U MRI, 2–6-mo interval) in all 29 cases | |
MRS Cho/Crn alone (lower) | Sensitivity: 75.0% Specificity: 81.0% Accuracy: 79% | |||||
PWI rCBV alone (lower) | Sensitivity: 87.5% Specificity: 85.7% Accuracy: 86% | |||||
MRS, DWI, and MRP Cho/Chon, ADC, CBV | Sensitivity: 100% Specificity: 95.2% Accuracy: 97% | |||||
Cha 2013 [21] | Retrospective case series (consecutive) | 16 Mets treated with SRS | DWI 3 layer pattern of ADC | Sensitivity: 100% Specificity: 87.5% Accuracy: 94% | Histological diagnosis by removal in all 16 cases | |
MRP rCBV ≤ 4.1 (retrospective) | Sensitivity: 100% Specificity: 71.4% Accuracy: 88% | |||||
DWI and perfusion MRI
3 layer pattern ADC
with rCBV ≤ 2.6 or rCBV ≤ 4.1 (retrospective) | Sensitivity: 100% Specificity: 100% Accuracy: 100% | |||||
Amin 2012 [22] | Retrospective case series | 24 primary brain tumors (7 GBMs, 12 AAs, 5 GI-IIAs) | MRS Cho/Cr < 1.5 and Cho/NAA < 1 (prospective) | 99mTc-DMSA-PET | Sensitivity: 100% Specificity: 61.1% Accuracy: 71% | 5 Histological (5B) and 19 clinical diagnosis (clinical course and F/U image) |
Ando 2004 [23] | Retrospective case series | 20 gliomas (10 GBMs, 2 AAs, 1 OD, 7 GI-IIAs) | MRS Cho/Cr < 1.5 (retrospective) | None | Sensitivity: 83.3% Specificity: 64.3% Accuracy: 70% | 7 Histological and 13 clinical diagnosis (MRI F/U ≥ 1 year) |
Elias 2011 [24] | Retrospective case series | 27 intracranial neoplasms | MRS Cho/NAA < 0.92 (Retrospective) | MRS Higher NAA/Cr, lower Cho/nNAA | Sensitivity: 90% Specificity: 86.7% Accuracy: 88% | 10 Histology and15 clinical diagnosis (3–6-mo F/U imaging) |
Huang 2011 [25] | Retrospective case series | 33 metastatic lesions | MRS 24 multivoxel MRS Cho/nCho ≤ 1.2 (retrospective) | Sensitivity: 100% Specificity: 33.3% Accuracy: 48% | 4 Histological and 29 clinical diagnosis (F/U image) | |
MRP rCBV ≤ 2 (retrospective) | Sensitivity: 100% Specificity: 55.6% Accuracy: 70% | |||||
Nakajima T 2009 [26] | Retrospective case series | 18 gliomas (8 GBMs, 6AAs, 4 DAs) | MRS Lac/Cho > 1.05 (retrospective) | MET-PET | Sensitivity: 88.9% Specificity: 100% Accuracy: 94% | 14 Histological and 4 clinical diagnosis (clinical course and F/U image ≥6 mos) |
Peca 2009 [27] | Retrospective case series | 15 GBMs after Stupp protocol | MRS neither increased Cho nor decreased NAA | None | Sensitivity: 25% Specificity: 100% Accuracy: 80% | 10 Histological and 5 clinical diagnosis (clinical and 3-mo interval MRI F/U) |
Zeng IJROBP 2007 [28] | Prospective cohort study | 55 HGGs (36 GIIIs, 19 GIVs) | MRS
Lower Cho/Cr and lower Cho/NAA
| Sensitivity: 100% Specificity: 93.8% Accuracy: 96% | 39 Histological (10B, 29R) and 16 clinical diagnosis (MRI F/U ≤ 22 mos) | |
Proton MRS and DWI
combination of Cho/Cr, Cho/NAA, ADC ratio (higher)
| Sensitivity: 100% Specificity: 93.8% Accuracy: 96% | |||||
Zeng JNO 2007 [29] | Prospective cohort study | 28 HGGs (20 GIIIs, 8 GIVs) | proton MRS Cho/Cr < 1.71, Cho/NAA < 1.71 (retrospective) | None | Sensitivity: 100% Specificity: 94.1% Accuracy: 96% | 21 Histological (5B, 16R) and 7 clinical diagnosis (F/U MRI) |
Jain 2011 [30] | Retrospective case series | 38 brain tumors | PCT
rCBV ≤ 1.5
PS ≤ 2.5 (retrospective) | None | Sensitivity: 90.9, 81.8% Specificity: 81.5, 81.5% Accuracy: 84, 82% | Histological diagnosis in all 38 cases |
Barajas 2009 [31] | Retrospective case series | 57 GBMs (66 examinations) | MRP rPH < 1.38 (retrospective) (blinded review) | None | Sensitivity: 80% Specificity: 89.1% Accuracy: 86% | 64 Histological (62R, 2B) and 2 clinical diagnosis (MRI F/U ≥ 22 mos) |
Bisdas 2011 [32] | Prospective cohort study | 18 HGGs | MRP Ktrans ≤ 0.19 (retrospective) | None | Sensitivity: 83.3% Specificity: 100% Accuracy: 94% | 5 Histological and 13 clinical diagnosis (MRI F/U ≥ 6 mos) |
Bobek-Billewicz 2011 [33] | Retrospective case series | 8 gliomas (11 lesions) (2 GBMs, 5 AAs, 1 DA) | MRP Normalized CBVmean ≤ 1.25 (retrospective) | DWI | Sensitivity: 100% Specificity: 60% Accuracy: 82% | 8 Histological and 3 clinical diagnosis (F/U image) |
Kim 2010 [34] | Retrospective case series | 10 HGGs (5 GBMs, 3 AAs, 2 AOs) | MRP
normalized rCBV ≤ 3.69
(retrospective) | 18F-FDG-PET, 11C-MET-PET | Sensitivity: 100% Specificity: 100% Accuracy: 100 | 3 Histological (3 R) and 7 clinical diagnosis (3-mo interval MRI F/U of 28 mos) |
Narang J 2011 [35] | Retrospective case series | 29 brain tumors (24 PBTs, 5 Mets) | MRP
nMSIVP < 0.031
(MSIVP ≤ 9.5)
(retrospective) | None | Sensitivity: 77.8% Specificity: 95% Accuracy: 90% | 20 Histological and 9 clinical diagnosis (imaging and clinical F/U ≦13 mos) |
References | Study Design | Patient | Exposure | Comparison | Outcome | Reference standard |
---|---|---|---|---|---|---|
Tie 2008 [19] | Retrospective case series (consecutive) | 19 HGGs (7 GBMs, 7 AAs, 5 AOs) (21 exams) | 201Tl-SPECT Visual assessment | MRI | Sensitivity 100.0% Specificity 82.4% Accuracy 85.7% | 9 Histological and12 clinical diagnosis (clinical and MRI F/U ≦6 mos) |
Gomez-Rio 2008 [36] | Prospective cohort study | Gliomas (44 HGGs, 32 LGGs) | 201Tl-SPECT
Visual assessment
(blind review) | Tl-SPECT + MRI vs FDG-PET + MRI | Sensitivity 85.7% Specificity 92.7% Accuracy 90.8% | 23 Histological and 53 clinical diagnosis (F/U image) |
Kahn 1994 [37] | Prospective cohort study | 17 Gliomas, 1 Met, 1 esthesioblastoma | 201Tl-SPECT Tl index | Sensitivity 40.0% Specificity 68.8% Accuracy 61.9% | 5 Histological and 14 clinical diagnosis (clinical F/U) (blinded review) | |
18F-FDG-PET
PET grade (visual assessment)
| Sensitivity 40.0% Specificity 81.3% Accuracy 71.4% | |||||
Matsunaga 2013 [38] | Retrospective case series | 27 Gliomas, 48 Mets (107 lesions) | 201Tl-SPECT Retention index ≤0.775 (retrospective) | None | Sensitivity 83.3% Specificity 83.1% Accuracy 83.2% | 19 Histological and 88 clinical diagnosis (clinical and MRI F/U) |
Stokkel 1999 [39] | Prospective cohort study | 16 Gliomas | 201Tl-SPECT
Tl uptake index
| Sensitivity 100.0% Specificity 100.0% Accuracy 100.0% | 2 Histological and14 clinical diagnosis (clinical and imaging F/U of 12 mos) | |
18F-FDG-PET
FDG grade (5-point scale)
| Sensitivity 100.0% Specificity 66.7% Accuracy 75.0% | |||||
Yamamoto 2002 [40] | Retrospective case series | 14 Gliomas, 4 Mets, 1 ML, 1 MM, 1 HPC | 201Tl-SPECT
L/N < 2.4
(retrospective) | Sensitivity 83.3% Specificity 93.3% Accuracy 90.5% | 10 Histological and 11 clinical diagnosis (F/U MRI for 10 mos) | |
Tc-MIBI –SPECT
L/N < 5.89
(retrospective) | Sensitivity 83.3% Specificity 93.3% Accuracy 90.5% | |||||
Le Jeune 2006 [41] | Retrospective case series | 81 Gliomas | Tc-MIBI –SPECT L/N < 2.0 (retrospective) | None | Sensitivity 93.2% Specificity 90.3% Accuracy 91.5% | 14 Histological (14 B) and 67 clinical diagnosis (clinical and image F/U ≥ 6 mos) |
Barai 2004 [42] | Retrospective case series (consecutive) | 73 Glioma | 99mTc-GHA-SPECT
GHA index (L/N)
< 2.0 (retrospective) (blind review) | None | Sensitivity 81.0% Specificity 98.1% Accuracy 93.2% | Clinical diagnosis (clinical F/U) in all 73 patients |
Belohlávek 2003 [43] | Retrospective case series (consecutive) | 25 Mets (57 lesions) | 18F-FDG-PET
Visual assessment
(blind review) | MRI | Sensitivity 93.9% Specificity 75.0% Accuracy 92.2% | 3 Histological and 54 clinical diagnosis (clinical and imaging F/U ≤ 26 weeks) |
Chao 2001 [44] | Retrospective case series | 15 Glioma, 32 Mets 44 lesions (8 glioma, 36 Mets) | 18F-FDG-PET
Visual assessment
| None | Sensitivity 81.3% Specificity 75.0% Accuracy 77.3% | 17 Histological and 27 clinical diagnosis (imaging F/U of 5.6 mos) |
Horky 2011 [45] | Retrospective case series (consecutive) | 32 Mets 25 patients with 27 lesions, 28 scans | 18F-FDG-PET L/N SUVmax change over time (ROC cutoff ≤ 0.19) (retrospective) | None | Sensitivity 100.0% Specificity 94.7% Accuracy 96.7% | 17 Histological and 13 clinical diagnosis (MRI F/U ≥ 6 mos) |
Karunanithi 2013 [46] | Prospective cohort study | 28 Gliomas | 18F-FDG-PET Visual assessment (T/W ratio ≤ 0.9) (retrospective) (blind review) | 18F-DOPA-PET | Sensitivity 100.0% Specificity 47.6% Accuracy 60.7% | 4 Histological and 24 clinical diagnosis (clinical and imaging F/U) |
Ozsunar 2010 [47] | Prospective cohort study | 30 Gliomas 26 PET evaluations | 18F-FDG-PET
Visual assessment
(blind review) | ASL imaging, DSCE-CBV imaging | Sensitivity 90.0% Specificity 81.3% Accuracy 84.6% | Histological diagnosis in all 35 evaluations |
Takenaka 2014 [48] | Retrospective case series (consecutive) | 50 Gliomas | 18F-FDG-PET
L/N ratio ≤ 1.26
(retrospective) | 11C-Cho-PET | Sensitivity 75.0% Specificity 76.5% Accuracy 76.0% | Histological diagnosis in all 50 patients |
11C-MET-PET L/N ratio ≤ 2.51 (retrospective) | 11C-Cho-PET | Sensitivity 87.5% Specificity 91.2% Accuracy 90.0% | ||||
Tan 2011 [49] | Retrospective case series | 37 Gliomas, 15 Mets, 1 neuroblastoma, 1 lymphoma, 1 germinoma | 18F-FDG-PET
visual assessment
| 11C-Cho-PET | Sensitivity 62.5% Specificity 76.9% Accuracy 72.7% | 17 Histological and 38 clinical diagnosis (3-m interval MRI F/U ≥ 11 mos) |
Okamoto 2011 [50] | Retrospective case series | 29 Gliomas and Mets 33 lesions | 11C-MET-PET
L/N ratio ≤ 1.4
(retrospective) | None | Sensitivity 90.0% Specificity 91.3% Accuracy 90.9% | 14 Histological and 19 clinical diagnosis (MRI over 2 yrs) |
Tsuyuguchi 2004 [51] | Retrospective case series | 11 HGGs (8 GBMs, 3 AAs) | 11C-MET-PET
Visual assessment
| Health volunteers | Sensitivity 100.0% Specificity 60.0% Accuracy 81.8% | 8 Histological and 3 clinical diagnosis (clinical and MRI F/U ≥ 5 mos) |
Yamane 2010 [52] | Retrospective case series (consecutive) | 80 brain neoplasms (47scans) | 11C-MET-PET visual assessment | None | Sensitivity 100.0% Specificity 88.1% Accuracy 89.4% | 30 Histological and 34 clinical diagnosis (clinical and imaging F/U of 435 days) |
Terakawa 2008 [53] | Retrospective case series | 26 Gliomas, 51 Mets 88 PETs | 11C-MET-PET
L/Nmean ratio
Met ≤ 1.41
Glioma ≤ 1.58
(retrospective) | None | Sensitivity 75.0% Specificity 77.5% Accuracy 76.1% | 44 Histological and 44 clinical diagnosis (MRI F/U ≥ 6mos) |
Saginoya 2012 [54] | Retrospective case series | 14 gliomas, 23 Mets, 2 lymphoma (49 scans) | 11C-MET-PET
L/N ratio ≤ 1.33
(retrospective) | None | Sensitivity 100.0% Specificity 72.0% Accuracy 85.7% | Histological and clinical diagnosis (imaging F/U ≥ 6 mos) |
Kawai 2008 [55] | Retrospective case series | 11 HGGs (13 scans), 14 Mets (15 scans) | 11C-MET-PET SUVmax ≤ 2.5 (glioma) (retrospective) | 18F-FLT-PET | Sensitivity 77.8% Specificity 76.9% Accuracy 77.3% | 12 histological and 10 clinical diagnosis (MRI F/U ≥ 1 yr) |
Sunada 2001 [56] | Retrospective case series | 26 Mets (33 lesions) | 11C-MET-PET visual assessment, T/N ratio | None | Sensitivity 83.3% Specificity 100.0% Accuracy 90.9% | 7 histological and 26 clinical diagnosis (imaging F/U ≥ 6 mos) |
Pӧpperl 2004 [57] | Retrospective case series | 53 Gliomas (27 GIVs, 16 GIIIs, 9 GIIs, 1 GI) | 18F-FET-PET SUVmax/BG ratio ≤ 2.0 (retrospective) | None | Sensitivity 100.0% Specificity 100.0% Accuracy 100.0% | 27 histological and 26 clinical diagnosis (clinical F/U of 34 mos) |
Rachinger 2005 [58] | Retrospective case series (consecutive) | 45 Gliomas (22 GIVs, 12 GIIIs, 10 GIIs, 1 GI) | 18F-FET-PET SUV MAX ≤ 2.2 (prospective) | MRI | Sensitivity 92.9% Specificity 100.0% Accuracy 97.8% | 32 histological and 13 clinical diagnosis (clinical F/U) |
Galldiks 2012 [59] | Retrospective case series (consecutive) | 31 Mets (40 lesions) | 18F-FET-PET TBR(tumor-to-brain ratio) mean ≤ 1.95 (retrospective) | None | Sensitivity 90.5% Specificity 73.7% Accuracy 82.5% | 11 histological and 29 clinical diagnosis (clinical and MRI F/U of 12 mos) |
Miyashita 2008 [60] | Retrospective case series | 38 Gliomas, 2 Mets, 2 Head and Neck cancers (49 scans) | 18F-BPA-PET L/Nmean ratio ≤ 2.5 (retrospective) | None | Sensitivity 100.0% Specificity 97.2% Accuracy 98.0% | 44 histological and 5 clinical diagnosis (MRI F/U > 4 mos) |