Accuracy of Susceptibility-Weighted Imaging and Dynamic Susceptibility Contrast Magnetic Resonance Imaging for Differentiating High-Grade Glioma from Primary Central Nervous System Lymphomas: Meta-Analysis.

Abstract

It is always a great challenge to distinguish high-grade glioma (HGG) from primary central nervous system lymphoma (PCNSL). We conducted a meta-analysis to assess the performance of dynamic susceptibility contrast (DSC) and susceptibility-weighted imaging (SWI) in differentiating HGGs from PCNSLs. Heterogeneity and threshold effect were evaluated, and sensitivity, specificity (SPE), and areas under the summary receiver operating characteristic curve (SROC) were calculated. Thirteen studies with a total of 704 participants were included in this meta-analysis. For the dynamic susceptibility contrast (DSC) technique, the pooled sensitivity and SPE were 0.94 and 0.84, respectively. The area under the curve (AUC) under the SROC was 0.9595, and the diagnostic odds ratio was 81.880. For the susceptibility weighted imaging (SWI) technique, the pooled sensitivity and SPE were 0.92 and 0.87, respectively. The AUC under the SROC was 0.9608, and the diagnostic odds ratio was 89.774. A Z test showed that no significant difference in AUC values between DSC and SWI (P= 0.97) was observed. In addition, no obvious public bias was observed in both the DSC (P= 0.69) and SWI (P= 0.32) groups. This meta-analysis indicated that both DSC-MRI and SWI have a high and similar level of diagnostic accuracy for differentiating HGGs from PCNSLs.