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European Radiology
Published in: European Radiology 8/2016

01-08-2016 | Magnetic Resonance

The diagnostic performance of magnetic resonance spectroscopy in differentiating high-from low-grade gliomas: A systematic review and meta-analysis

Authors: Qun Wang, Hui Zhang, JiaShu Zhang, Chen Wu, WeiJie Zhu, FangYe Li, XiaoLei Chen, BaiNan Xu

Published in: European Radiology | Issue 8/2016

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Abstract

Objective

Magnetic resonance spectroscopy (MRS) is a powerful tool for preoperative grading of gliomas. We performed a meta-analysis to evaluate the diagnostic performance of MRS in differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs).

Methods

PubMed and Embase databases were systematically searched for relevant studies of glioma grading assessed by MRS through 27 March 2015. Based on the data from eligible studies, pooled sensitivity, specificity, diagnostic odds ratio and areas under summary receiver operating characteristic curve (SROC) of different metabolite ratios were obtained.

Results

Thirty articles comprising a total sample size of 1228 patients were included in our meta-analysis. Quantitative synthesis of studies showed that the pooled sensitivity/specificity of Cho/Cr, Cho/NAA and NAA/Cr ratios was 0.75/0.60, 0.80/0.76 and 0.71/0.70, respectively. The area under the curve (AUC) of the SROC was 0.83, 0.87 and 0.78, respectively.

Conclusions

MRS demonstrated moderate diagnostic performance in distinguishing HGGs from LGGs using tumoural metabolite ratios including Cho/Cr, Cho/NAA and NAA/Cr. Although there was no significant difference in AUC between Cho/Cr and Cho/NAA groups, Cho/NAA ratio showed higher sensitivity and specificity than Cho/Cr ratio and NAA/Cr ratio. We suggest that MRS should combine other advanced imaging techniques to improve diagnostic accuracy in differentiating HGGs from LGGs.

Key points

• MRS has moderate diagnostic performance in distinguishing HGGs from LGGs.
• There is no significant difference in AUC between Cho/Cr and Cho/NAA ratios.
• Cho/NAA ratio is superior to NAA/Cr ratio.
• Cho/NAA ratio shows higher sensitivity and specificity than Cho/Cr and NAA/Cr ratios.
• MRS should combine other advanced imaging techniques to improve diagnostic accuracy.
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Metadata
Title
The diagnostic performance of magnetic resonance spectroscopy in differentiating high-from low-grade gliomas: A systematic review and meta-analysis
Authors
Qun Wang
Hui Zhang
JiaShu Zhang
Chen Wu
WeiJie Zhu
FangYe Li
XiaoLei Chen
BaiNan Xu
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4046-z

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