Non-contrast Magnetic Resonance Imaging for Diagnosis and Monitoring of Vestibular Schwannomas: A Systematic Review and Meta-analysis.

Abstract

This study aimed to evaluate the diagnostic accuracy of high-resolution T2-weighted magnetic resonance imaging (T2wi) in terms of detecting vestibular schwannoma compared with gadolinium-enhanced T1-weighted MRI (GdT1wi). Five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database). Two authors independently searched five databases up to January 2019 on diagnosis of vestibular schwannomas via T2wi. In the included studies, tumor diameters reported using T2wi were compared with those revealed by GdT1wi and correlation coefficients were calculated. Data on true-positives, true-negatives, false-positives, and false-negatives were extracted from the relevant articles. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Inter-rater agreement among different observers and intra-rater agreement among different measurements made by a single observer was assessed. Outcomes subjected to analysis included diagnostic accuracy (the diagnostic odds ratio); summary receiver operating characteristic curve and area under the curve values. The summary intra-class correlation coefficient was used for various random-effects models. The quality of each study was analyzed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. T2wi performed without the use of a contrast agent is a highly accurate diagnostic and monitor tool compared with GdT1wi and also demonstrated high reliability. However, further studies are required to confirm the results of this study.