Application of dynamic susceptibility weighted contrast enhanced and DWI in differential diagnosis of brain tumor recurrence from radiation necrosis

Abstract

Objective The study was designed to compare the diagnostic accuracy of diffusion weighted imaging (DWI) with dynamic susceptibility-contrast (DSC) MRI in differentiating radiation necrosis from tumor recurrence in patients with brain tumor. Methods Relevant Studies about DWI and DSC in differentiating radiation necrosis from tumor recurrence in PubMed, EMBASE, Web of Science and Cochrane databases were searched for relevant articles up to November 2017. Two authors independently selected and screened studies that met the inclusion criteria. Pooled SEN, SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated. Results A total of 14 surveys that investigated DSC or DWI for differentiating radiation necrosis from tumor recurrence were included. The current study found that pooled sensitivity and specificity of DSC in differentiating radiation necrosis from tumor recurrence were 0.88(95% CI: 0.82-0.93) and 0.85(95%CI: 0.77-0.91), respectively. The same measures for DWI were 0.84(95% CI: 0.77-0.89) and 0.84(95%CI: 0.73-0.90), respectively. Moreover, DSC appeared to have higher diagnostic odds ratio than DWI (33 vs. 20). Another important finding was the AUC of DSC higher, compared to DWI, in detection radiation necrosis from tumor recurrence (94% vs. 88%). Conclusion Base on the results of the present meta-analysis, DSC was found to be superior to DWI in differentiating brain tumor recurrence from radiation necrosis. Key words: DSC; DWI; Radiation necrosis; Tumor recurrence