Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis

N Verburg, F W A Hoefnagels, F Barkhof, R Boellaard, S Goldman, J Guo, J J Heimans, O S Hoekstra, R Jain, M Kinoshita, P J W Pouwels, S J Price, J C Reijneveld, A Stadlbauer, W P Vandertop, P Wesseling, A H Zwinderman, P C De Witt Hamer

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.

PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.

DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.

STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.

DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.

DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and 11C methionine-PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.

LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.

CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.

Original languageEnglish
Pages (from-to)1884-1891
Number of pages8
JournalAmerican Journal of Neuroradiology
Volume38
Issue number10
DOIs
Publication statusPublished - Oct 2017

Cite this

@article{282314d93dea45319d3087814e47a122,
title = "Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis",
abstract = "BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6{\%}, 3.3{\%}, 82{\%}, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0{\%}, 0.4{\%}, 44.7{\%}, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7{\%}, 16.8{\%}, 73.3{\%}, and 14.8. In high-grade gliomas, MR spectroscopy (85.7{\%}, 35.0{\%}, 85.7{\%}, and 12.4) and 11C methionine-PET (85.1{\%}, 38.7{\%}, 93.7{\%}, and 26.6) performed better than the reference imaging.LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.",
keywords = "Journal Article",
author = "N Verburg and Hoefnagels, {F W A} and F Barkhof and R Boellaard and S Goldman and J Guo and Heimans, {J J} and Hoekstra, {O S} and R Jain and M Kinoshita and Pouwels, {P J W} and Price, {S J} and Reijneveld, {J C} and A Stadlbauer and Vandertop, {W P} and P Wesseling and Zwinderman, {A H} and {De Witt Hamer}, {P C}",
note = "{\circledC} 2017 by American Journal of Neuroradiology.",
year = "2017",
month = "10",
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language = "English",
volume = "38",
pages = "1884--1891",
journal = "American Journal of Neuroradiology",
issn = "0195-6108",
publisher = "American Society of Neuroradiology",
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}

Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain : A Meta-Analysis. / Verburg, N; Hoefnagels, F W A; Barkhof, F; Boellaard, R; Goldman, S; Guo, J; Heimans, J J; Hoekstra, O S; Jain, R; Kinoshita, M; Pouwels, P J W; Price, S J; Reijneveld, J C; Stadlbauer, A; Vandertop, W P; Wesseling, P; Zwinderman, A H; De Witt Hamer, P C.

In: American Journal of Neuroradiology, Vol. 38, No. 10, 10.2017, p. 1884-1891.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain

T2 - A Meta-Analysis

AU - Verburg, N

AU - Hoefnagels, F W A

AU - Barkhof, F

AU - Boellaard, R

AU - Goldman, S

AU - Guo, J

AU - Heimans, J J

AU - Hoekstra, O S

AU - Jain, R

AU - Kinoshita, M

AU - Pouwels, P J W

AU - Price, S J

AU - Reijneveld, J C

AU - Stadlbauer, A

AU - Vandertop, W P

AU - Wesseling, P

AU - Zwinderman, A H

AU - De Witt Hamer, P C

N1 - © 2017 by American Journal of Neuroradiology.

PY - 2017/10

Y1 - 2017/10

N2 - BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and 11C methionine-PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.

AB - BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and 11C methionine-PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.

KW - Journal Article

U2 - 10.3174/ajnr.A5368

DO - 10.3174/ajnr.A5368

M3 - Article

VL - 38

SP - 1884

EP - 1891

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 10

ER -