Hanmei Zhang1, Qi Gan2, Yinghua Wu3, Rongbo Liu1, Xijiao Liu1, Zixing Huang1, Fang Yuan1, Min Kuang3, Bin Song4. 1. Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China. 2. Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China. 3. Department of Radiology, The Second Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, No. 15, Section 4 Renmin South Road, Chengdu, 610041, Sichuan, China. 4. Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China. cjr.songbin@vip.163.com.
Abstract
PURPOSE: This study aims to quantitatively evaluate the potential of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiating malignant and benign human renal lesions. MATERIALS AND METHODS: A systematic literature was performed to identify previous research related to the diagnostic performance of DW-MRI for determining whether human renal lesions were benign or malignant. ADC values were extracted from normal renal tissue and different lesion types. Data were extracted to assess the diagnostic performance of DW-MRI for differentiating malignant and benign human renal lesions, as well as running threshold effect and heterogeneity. RESULTS: Nine publications with 11 subsets were eligible for data extraction and diagnostic performance calculation. A total of 988 apparent diffusion coefficient (ADC) measurements were included. The differences in ADC values between benign lesions (2.47 ± 0.81 × 10(-3) mm(2)/s) and malignant lesions (1.81 ± 0.41 × 10(-3) mm(2)/s) were statistically significant (P < 0.001). The diagnostic odds ratio, the overall positive, negative likelihood ratios, pooled weighted sensitivity and specificity with 95% CI were 20.05 (95% CI 12.56-32.02), 3.32 (95% CI 2.13-5.18), 0.20 (95% CI 0.15-0.27), 88% (95% CI 0.84-0.91) and 72% (95% CI 0.67-0.76), respectively. The area under the curve of the summary receiver operating characteristic was 0.90. CONCLUSIONS: This meta-analysis indicated that DW-MRI had a relatively good diagnostic accuracy in differentiating malignant and benign human renal lesions. We preliminarily recommend that DW-MRI is performed with a maximum b value ranging from 800 to 1000 s/mm(2) at 3.0 T for imaging protocol, and that DW-MRI should be used with caution when the study population includes children.
PURPOSE: This study aims to quantitatively evaluate the potential of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiating malignant and benign humanrenal lesions. MATERIALS AND METHODS: A systematic literature was performed to identify previous research related to the diagnostic performance of DW-MRI for determining whether humanrenal lesions were benign or malignant. ADC values were extracted from normal renal tissue and different lesion types. Data were extracted to assess the diagnostic performance of DW-MRI for differentiating malignant and benign humanrenal lesions, as well as running threshold effect and heterogeneity. RESULTS: Nine publications with 11 subsets were eligible for data extraction and diagnostic performance calculation. A total of 988 apparent diffusion coefficient (ADC) measurements were included. The differences in ADC values between benign lesions (2.47 ± 0.81 × 10(-3) mm(2)/s) and malignant lesions (1.81 ± 0.41 × 10(-3) mm(2)/s) were statistically significant (P < 0.001). The diagnostic odds ratio, the overall positive, negative likelihood ratios, pooled weighted sensitivity and specificity with 95% CI were 20.05 (95% CI 12.56-32.02), 3.32 (95% CI 2.13-5.18), 0.20 (95% CI 0.15-0.27), 88% (95% CI 0.84-0.91) and 72% (95% CI 0.67-0.76), respectively. The area under the curve of the summary receiver operating characteristic was 0.90. CONCLUSIONS: This meta-analysis indicated that DW-MRI had a relatively good diagnostic accuracy in differentiating malignant and benign humanrenal lesions. We preliminarily recommend that DW-MRI is performed with a maximum b value ranging from 800 to 1000 s/mm(2) at 3.0 T for imaging protocol, and that DW-MRI should be used with caution when the study population includes children.
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