Qun Wang1, Hui Zhang2, JiaShu Zhang1, Chen Wu1, WeiJie Zhu3, FangYe Li1, XiaoLei Chen4, BaiNan Xu5. 1. Department of Neurosurgery, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China. 2. Department of Neurosurgery, Air Force General Hospital of the Chinese PLA, 30 Fucheng Road, Haidian District, Beijing, 100142, China. 3. Department of Neurosurgery, General Hospital, Ji'nan Military Area Command, Ji'nan, 250032, China. 4. Department of Neurosurgery, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China. cxl73@msn.com. 5. Department of Neurosurgery, Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China. bn_xu@yahoo.com.
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.
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.
Entities:
Keywords:
Differentiation; Glioma; Magnetic resonance spectroscopy; Meta-analysis; Systematic review
Authors: Afina S Glas; Jeroen G Lijmer; Martin H Prins; Gouke J Bonsel; Patrick M M Bossuyt Journal: J Clin Epidemiol Date: 2003-11 Impact factor: 6.437
Authors: Frederic G Dhermain; Peter Hau; Heinrich Lanfermann; Andreas H Jacobs; Martin J van den Bent Journal: Lancet Neurol Date: 2010-08-10 Impact factor: 44.182
Authors: Mariska M G Leeflang; Jonathan J Deeks; Constantine Gatsonis; Patrick M M Bossuyt Journal: Ann Intern Med Date: 2008-12-16 Impact factor: 25.391
Authors: Bhaswati Roy; Rakesh K Gupta; Andrew A Maudsley; Rishi Awasthi; Sulaiman Sheriff; Meng Gu; Nuzhat Husain; Sudipta Mohakud; Sanjay Behari; Chandra M Pandey; Ram K S Rathore; Daniel M Spielman; Jeffry R Alger Journal: Neuroradiology Date: 2013-02-02 Impact factor: 2.804
Authors: Jörg Mauler; Andrew A Maudsley; Karl-Josef Langen; Omid Nikoubashman; Gabriele Stoffels; Sulaiman Sheriff; Philipp Lohmann; Christian Filss; Norbert Galldiks; Elena Rota Kops; N Jon Shah Journal: J Nucl Med Date: 2017-08-28 Impact factor: 10.057
Authors: Young Jin Heo; Ji Eun Park; Ho Sung Kim; Ji Ye Lee; Soo Jeong Nam; Seung Chai Jung; Choong Gon Choi; Sang Joon Kim Journal: Eur Radiol Date: 2016-11-17 Impact factor: 5.315
Authors: Gilbert Hangel; Saurabh Jain; Elisabeth Springer; Eva Hečková; Bernhard Strasser; Michal Považan; Stephan Gruber; Georg Widhalm; Barbara Kiesel; Julia Furtner; Matthias Preusser; Thomas Roetzer; Siegfried Trattnig; Diana M Sima; Dirk Smeets; Wolfgang Bogner Journal: Neuroimage Date: 2019-02-14 Impact factor: 6.556
Authors: Andrew A Maudsley; Ovidiu C Andronesi; Peter B Barker; Alberto Bizzi; Wolfgang Bogner; Anke Henning; Sarah J Nelson; Stefan Posse; Dikoma C Shungu; Brian J Soher Journal: NMR Biomed Date: 2020-04-29 Impact factor: 4.044
Authors: Martina Sebök; Christiaan Hendrik Bas van Niftrik; Giovanni Muscas; Athina Pangalu; Katharina Seystahl; Michael Weller; Luca Regli; Jorn Fierstra Journal: Neurooncol Adv Date: 2021-03-30