Abstract
We conducted a meta-analysis to evaluate the diagnostic values of mean cerebral blood volume for recurrent and radiation injury in glioma patients. We performed systematic electronic searches for eligible study up to August 8, 2016. Bivariate mixed effects models were used to estimate the combined sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, diagnostic odds ratios and their 95% confidence intervals (CIs). Fifteen studies with a total number of 576 participants were enrolled. The pooled sensitivity and specificity of diagnostic were 0.88 (95%CI: 0.82-0.92) and 0.85 (95%CI: 0.68-0.93). The pooled positive likelihood ratio is 5.73 (95%CI: 2.56-12.81), negative likelihood ratio is 0.15 (95%CI: 0.10-0.22), and the diagnostic odds ratio is 39.34 (95%CI:13.96-110.84). The summary receiver operator characteristic is 0.91 (95%CI: 0.88-0.93). However, the Deek's plot suggested publication bias may exist (t=2.30, P=0.039). Mean cerebral blood volume measurement methods seems to be very sensitive and highly specific to differentiate recurrent and radiation injury in glioma patients. The results should be interpreted with caution because of the potential bias.
Highlights
Gliomas represent approximately 30% of all central nervous system tumors and 80% of malignant brain tumors [1]
Our study suggested that mean cerebral blood volume could aid in the prediction of the presence of recurrent and radiation injury in glioma patients (AUC=0.91)
The necrosis areas of cerebral tissue caused by radiation therapy presented different characteristics
Summary
Gliomas represent approximately 30% of all central nervous system tumors and 80% of malignant brain tumors [1]. The methods of 6-week radiation therapy and concomitant temozolomide chemotherapy and 6 times of adjuvant temozolomide chemotherapy after surgical resection are widely employed in the treatment scheme [2]. This treatment protocol increased the risk of brain tissue radiation injury and recurrent in patients with glioma. Previous studies suggested that enlarged and enhanced lesions on MR images may represent pseudoprogression in 46.8-64% of the cases [4]. Because the ADC values in necrotic are usually higher than recurrent tissue This method is limited because of the differences of tumor type. Reduced diffusion can represent highly cellular tumor areas and inflammatory [5]
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