Arterial spin labeling MR imaging for differentiation between high- and low-grade glioma - A meta-analysis

Research output: Contribution to journalArticle

Standard

Arterial spin labeling MR imaging for differentiation between high- and low-grade glioma - A meta-analysis. / Falk Delgado, Alberto; De Luca, Francesca; Van Westen, Danielle; Falk Delgado, Anna.

In: Neuro-Oncology, Vol. 20, No. 11, 2018, p. 1450-1461.

Research output: Contribution to journalArticle

Harvard

APA

CBE

MLA

Vancouver

Author

Falk Delgado, Alberto ; De Luca, Francesca ; Van Westen, Danielle ; Falk Delgado, Anna. / Arterial spin labeling MR imaging for differentiation between high- and low-grade glioma - A meta-analysis. In: Neuro-Oncology. 2018 ; Vol. 20, No. 11. pp. 1450-1461.

RIS

TY - JOUR

T1 - Arterial spin labeling MR imaging for differentiation between high- and low-grade glioma - A meta-analysis

AU - Falk Delgado, Alberto

AU - De Luca, Francesca

AU - Van Westen, Danielle

AU - Falk Delgado, Anna

PY - 2018

Y1 - 2018

N2 - Background. Arterial spin labeling is an MR imaging technique that measures cerebral blood flow (CBF) noninvasively. The aim of the study is to assess the diagnostic performance of arterial spin labeling (ASL) MR imaging for differentiation between high-grade glioma and low-grade glioma. Methods. Cochrane Library, Embase, Medline, and Web of Science Core Collection were searched. Study selection ended November 2017. This study was prospectively registered in PROSPERO (CRD42017080885). Two authors screened all titles and abstracts for possible inclusion. Data were extracted independently by 2 authors. Bivariate random effects meta-analysis was used to describe summary receiver operating characteristics. Trial sequential analysis (TSA) was performed. Results. In total, 15 studies with 505 patients were included. The diagnostic performance of ASL CBF for glioma grading was 0.90 with summary sensitivity 0.89 (0.79-0.90) and specificity 0.80 (0.72-0.89). The diagnostic performance was similar between pulsed ASL (AUC 0.90) with a sensitivity 0.85 (0.71-0.91) and specificity 0.83 (0.69- 0.92) and pseudocontinuous ASL (AUC 0.88) with a sensitivity 0.86 (0.79-0.91) and specificity 0.80 (0.65-0.87). In astrocytomas, the diagnostic performance was 0.89 with sensitivity 0.86 (0.79 to 0.91) and specificity 0.79 (0.63 to 0.89). Sensitivity analysis confirmed the robustness of the findings. TSA revealed that the meta-analysis was adequately powered. Conclusion. Arterial spin labeling MR imaging had an excellent diagnostic accuracy for differentiation between high-grade and low-grade glioma. Given its low cost, non-invasiveness, and efficacy, ASL MR imaging should be considered for implementation in the routine workup of patients with glioma.

AB - Background. Arterial spin labeling is an MR imaging technique that measures cerebral blood flow (CBF) noninvasively. The aim of the study is to assess the diagnostic performance of arterial spin labeling (ASL) MR imaging for differentiation between high-grade glioma and low-grade glioma. Methods. Cochrane Library, Embase, Medline, and Web of Science Core Collection were searched. Study selection ended November 2017. This study was prospectively registered in PROSPERO (CRD42017080885). Two authors screened all titles and abstracts for possible inclusion. Data were extracted independently by 2 authors. Bivariate random effects meta-analysis was used to describe summary receiver operating characteristics. Trial sequential analysis (TSA) was performed. Results. In total, 15 studies with 505 patients were included. The diagnostic performance of ASL CBF for glioma grading was 0.90 with summary sensitivity 0.89 (0.79-0.90) and specificity 0.80 (0.72-0.89). The diagnostic performance was similar between pulsed ASL (AUC 0.90) with a sensitivity 0.85 (0.71-0.91) and specificity 0.83 (0.69- 0.92) and pseudocontinuous ASL (AUC 0.88) with a sensitivity 0.86 (0.79-0.91) and specificity 0.80 (0.65-0.87). In astrocytomas, the diagnostic performance was 0.89 with sensitivity 0.86 (0.79 to 0.91) and specificity 0.79 (0.63 to 0.89). Sensitivity analysis confirmed the robustness of the findings. TSA revealed that the meta-analysis was adequately powered. Conclusion. Arterial spin labeling MR imaging had an excellent diagnostic accuracy for differentiation between high-grade and low-grade glioma. Given its low cost, non-invasiveness, and efficacy, ASL MR imaging should be considered for implementation in the routine workup of patients with glioma.

KW - abeling

KW - arteria

KW - brain tumors

KW - CNS

KW - glioma

KW - imaging

KW - spin

U2 - 10.1093/neuonc/noy095

DO - 10.1093/neuonc/noy095

M3 - Article

VL - 20

SP - 1450

EP - 1461

JO - Neuro-Oncology

JF - Neuro-Oncology

SN - 1523-5866

IS - 11

ER -