Arterial Spin-Labeling in Children with Brain Tumor: A Meta-Analysis

Area of Science:

• Neuroimaging
• Pediatric Oncology
• Medical Diagnostics

Background:

• Arterial spin-labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF).
• The diagnostic value of ASL in pediatric brain tumors has not been previously evaluated through meta-analysis.

Purpose of the Study:

• To determine the diagnostic accuracy of ASL-derived CBF in differentiating between low- and high-grade pediatric brain tumors.
• To assess the reliability of both relative and absolute CBF measurements.

Main Methods:

• A systematic literature search was conducted across major databases (MEDLINE, EMBASE, Web of Science, Cochrane Library).
• Included studies involved pediatric patients with ASL MRI and confirmed neuropathologic diagnoses.
• Bivariate meta-analysis and meta-regression were employed to synthesize data and explore heterogeneity.

Main Results:

• Eight studies with 286 pediatric patients were included in the meta-analysis.
• ASL demonstrated high diagnostic accuracy, with pooled sensitivity and specificity for relative CBF ranging from 0.75-0.90 and 0.77-0.92, respectively (AUC = 0.92).
• Relative CBF exhibited less heterogeneity (I² = 38) compared to absolute CBF (I² = 74), indicating greater consistency across studies.

Conclusions:

• ASL-derived CBF measurements are highly accurate for discriminating low- and high-grade pediatric brain tumors.
• Relative CBF measurements from ASL are more consistent across studies than absolute CBF, making them a valuable tool for clinical assessment.