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European Radiology
Published in: European Radiology 10/2017

Open Access 01-10-2017 | Magnetic Resonance

Diagnostic accuracy of magnetic resonance imaging techniques for treatment response evaluation in patients with high-grade glioma, a systematic review and meta-analysis

Authors: Bart R. J. van Dijken, Peter Jan van Laar, Gea A. Holtman, Anouk van der Hoorn

Published in: European Radiology | Issue 10/2017

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Abstract

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).

Conclusion

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

Key points

• 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
Appendix
Available only for authorised users
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Metadata
Title
Diagnostic accuracy of magnetic resonance imaging techniques for treatment response evaluation in patients with high-grade glioma, a systematic review and meta-analysis
Authors
Bart R. J. van Dijken
Peter Jan van Laar
Gea A. Holtman
Anouk van der Hoorn
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4789-9

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