Hui Zhang1, Li Ma2, Qun Wang3, Xuan Zheng3, Chen Wu3, Bai-Nan Xu4. 1. Department of Neurosurgery, Air Force General Hospital of the Chinese PLA, 30 Fucheng Road, Haidian District, Beijing 100142, China; Department of Neurosurgery, Chinese PLA General Hospital, 28 Fuxing Road,Haidian District, Beijing 100853, China. 2. Department of Anesthesiology, Beijing Military General Hospital, Beijing 100700, China. 3. Department of Neurosurgery, Chinese PLA General Hospital, 28 Fuxing Road,Haidian District, Beijing 100853, China. 4. Department of Neurosurgery, Chinese PLA General Hospital, 28 Fuxing Road,Haidian District, Beijing 100853, China. Electronic address: bn_xu@yahoo.com.
Abstract
PURPOSE: Differentiating glioma recurrence from radiation necrosis remains a great challenge. We conducted a meta-analysis to evaluate the diagnostic quality of magnetic resonance spectroscopy (MRS) in differentiating glioma recurrence from radiation necrosis. METHODS: Studies about evaluation of MRS for the differential diagnosis of glioma recurrence from radiation necrosis were systematically searched in PubMed, Embase and Chinese Biomedical databases up to May 4, 2014. The data were extracted to perform heterogeneity test, threshold effect test and to calculate sensitivity (SEN), specificity (SPE) and areas under summary receiver operating characteristic curve (SROC). RESULTS: Eighteen articles comprising a total sample size of 455 patients (447 lesions) with suspected glioma recurrence after radiotherapy, met all inclusion and exclusion criteria, and were included in our meta-analysis. Quantitative synthesis of studies showed that the pooled SEN and SPE for Cho/Cr ratio were 0.83 (95% CI: 0.77, 0.89) and 0.83 (95% CI: 0.74, 0.90). The area under the curve (AUC) under the SROC was 0.9001. The pooled SEN and SPE for Cho/NAA ratio were 0.88 (95% CI: 0.81, 0.93) and 0.86 (95% CI: 0.76, 0.93). The AUC under the SROC was 0.9185. CONCLUSION: This meta-analysis shows that MRS alone has moderate diagnostic performance in differentiating glioma recurrence from radiation necrosis using metabolite ratios like Cho/Cr and Cho/NAA ratio. It is strongly recommended that MRS should combine other advanced imaging technologies to improve diagnostic accuracy. This article underlines the importance of implementing multimodal imaging trials and multicentre trials in the future.
PURPOSE: Differentiating glioma recurrence from radiation necrosis remains a great challenge. We conducted a meta-analysis to evaluate the diagnostic quality of magnetic resonance spectroscopy (MRS) in differentiating glioma recurrence from radiation necrosis. METHODS: Studies about evaluation of MRS for the differential diagnosis of glioma recurrence from radiation necrosis were systematically searched in PubMed, Embase and Chinese Biomedical databases up to May 4, 2014. The data were extracted to perform heterogeneity test, threshold effect test and to calculate sensitivity (SEN), specificity (SPE) and areas under summary receiver operating characteristic curve (SROC). RESULTS: Eighteen articles comprising a total sample size of 455 patients (447 lesions) with suspected glioma recurrence after radiotherapy, met all inclusion and exclusion criteria, and were included in our meta-analysis. Quantitative synthesis of studies showed that the pooled SEN and SPE for Cho/Cr ratio were 0.83 (95% CI: 0.77, 0.89) and 0.83 (95% CI: 0.74, 0.90). The area under the curve (AUC) under the SROC was 0.9001. The pooled SEN and SPE for Cho/NAA ratio were 0.88 (95% CI: 0.81, 0.93) and 0.86 (95% CI: 0.76, 0.93). The AUC under the SROC was 0.9185. CONCLUSION: This meta-analysis shows that MRS alone has moderate diagnostic performance in differentiating glioma recurrence from radiation necrosis using metabolite ratios like Cho/Cr and Cho/NAA ratio. It is strongly recommended that MRS should combine other advanced imaging technologies to improve diagnostic accuracy. This article underlines the importance of implementing multimodal imaging trials and multicentre trials in the future.
Authors: Robert H Press; Jim Zhong; Saumya S Gurbani; Brent D Weinberg; Bree R Eaton; Hyunsuk Shim; Hui-Kuo G Shu Journal: Neurosurgery Date: 2019-08-01 Impact factor: 4.654
Authors: Marina Radoul; Chloé Najac; Pavithra Viswanath; Joydeep Mukherjee; Mark Kelly; Anne Marie Gillespie; Myriam M Chaumeil; Pia Eriksson; Romelyn Delos Santos; Russell O Pieper; Sabrina M Ronen Journal: NMR Biomed Date: 2018-12-18 Impact factor: 4.044