Diagnostic performance of DSC perfusion MRI to distinguish tumor progression and treatment-related changes: a systematic review and meta-analysis.

Autor:	Fu R; Oregon Health & Science University-Portland State University, School of Public Health, Portland, Oregon, USA.; Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA., Szidonya L; Department of Radiology, Oregon Health & Science University, Portland, Oregon, USA.; Neuro-Oncology Program, Oregon Health & Science University, Portland, Oregon, USA.; Heart and Vascular Center, Diagnostic Radiology, Semmelweis University, Budapest, Hungary., Barajas RF Jr; Department of Radiology, Oregon Health & Science University, Portland, Oregon, USA.; Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA.; Knight Cancer Institute Translational Oncology Program, Oregon Health & Science University, Portland, Oregon, USA., Ambady P; Neuro-Oncology Program, Oregon Health & Science University, Portland, Oregon, USA., Varallyay C; Department of Radiology, EPIC Imaging, Portland, Oregon, USA., Neuwelt EA; Neuro-Oncology Program, Oregon Health & Science University, Portland, Oregon, USA.; Department of Neurosurgery, Oregon Health and Sciences University, Portland, Oregon, USA.; Office of Research and Development, Department of Veterans Affairs Medical Center, Portland, Oregon, USA.
Jazyk:	angličtina
Zdroj:	Neuro-oncology advances [Neurooncol Adv] 2022 Mar 01; Vol. 4 (1), pp. vdac027. Date of Electronic Publication: 2022 Mar 01 (Print Publication: 2022).
DOI:	10.1093/noajnl/vdac027
Abstrakt:	Background: In patients with high-grade glioma (HGG), true disease progression and treatment-related changes often appear similar on magnetic resonance imaging (MRI), making it challenging to evaluate therapeutic response. Dynamic susceptibility contrast (DSC) MRI has been extensively studied to differentiate between disease progression and treatment-related changes. This systematic review evaluated and synthesized the evidence for using DSC MRI to distinguish true progression from treatment-related changes. Methods: We searched Ovid MEDLINE and the Ovid MEDLINE in-process file (January 2005-October 2019) and the reference lists. Studies on test performance of DSC MRI using relative cerebral blood volume in HGG patients were included. One investigator abstracted data, and a second investigator confirmed them; two investigators independently assessed study quality. Meta-analyses were conducted to quantitatively synthesize area under the receiver operating curve (AUROC), sensitivity, and specificity. Results: We screened 1177 citations and included 28 studies with 638 patients with true tumor progression, and 430 patients with treatment-related changes. Nineteen studies reported AUROC and the combined AUROC is 0.85 (95% CI, 0.81-0.90). All studies contributed data for sensitivity and specificity, and the pooled sensitivity and specificity are 0.84 (95% CI, 0.80-0.88), and 0.78 (95% CI, 0.72-0.83). Extensive subgroup analyses based on study, treatment, and imaging characteristics generally showed similar results. Conclusions: There is moderate strength of evidence that relative cerebral blood volume obtained from DSC imaging demonstrated "excellent" ability to discriminate true tumor progression from treatment-related changes, with robust sensitivity and specificity. (© The Author(s) 2022. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.)
Databáze:	MEDLINE
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