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

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