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Diagnostic performance of diffusion and perfusion MRI in differentiating high from low-grade meningiomas: A
Timoleon Siempis1, Charalampos Tsakiris1, George A Alexiou1
1Department of Neurosurgery, Medical School, University of Ioannina, Greece.
Objectives:
The purpose of the present meta-analysis and systematic review was to evaluate the currently published data on the potential role of perfusion (PWI) and diffusion (DWI) weighted imaging for the assessment of meningioma grade.
Patients And Methods:
A search of MEDLINE and relative reference lists was conducted to identify all the eligible studies assessing the diagnostic performance of DWI and PWI in grading meningiomas. Meta-Disc and Rev-Man were used for the statistical analysis. Methodological quality and risk of bias were assessed with the use of the updated Quality assessment of the diagnostic accuracy (QUADAS-2) tool. Pooled sensitivity, specificity and area under the summary receiver operating characteristic curve were calculated individually for DWI and PWI to demonstrate the diagnostic performance of each modality.
Results:
Fourteen studies with 1063 patients were included. The 8 studies evaluating DWI showed a pooled sensitivity of 80% (95% CI, 74%-86%) and a pooled specificity of 76% (95% CI, 72%-79%). As for the 6 remaining studies concerning PWI, the pooled sensitivity and specificity were found 80% (95% CI, 71%-88%) and 91% (95% CI, 87%-94%), respectively. The area under the SROC curve was 0.94 (95% CI) for PWI and 0.91 (95% CI) for DWI. The comparison of the two AUCs showed that neither technique was superior with regards to the diagnostic performance.
Conclusions:
The current evidence proves that both techniques are efficient at differentiating high from low-grade meningiomas.
Insights
Perfusion (PWI) and diffusion (DWI) weighted imaging are effective for grading meningiomas. Both techniques show similar diagnostic performance in differentiating high- from low-grade tumors.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Meningiomas are the most common primary intracranial tumors.
- Accurate grading of meningiomas is crucial for treatment planning and prognosis.
- Non-invasive imaging techniques are needed to assess tumor grade.
Purpose of the Study:
- To systematically review and meta-analyze published data on the role of perfusion (PWI) and diffusion (DWI) weighted imaging in assessing meningioma grade.
- To evaluate the diagnostic performance of DWI and PWI in differentiating high-grade from low-grade meningiomas.
Main Methods:
- A systematic literature search was conducted on MEDLINE and reference lists.
- Fourteen studies including 1063 patients were analyzed.
- Pooled sensitivity, specificity, and area under the summary receiver operating characteristic curve (SROC) were calculated for DWI and PWI.
- Methodological quality and risk of bias were assessed using the QUADAS-2 tool.
Main Results:
- DWI demonstrated a pooled sensitivity of 80% and specificity of 76%.
- PWI showed a pooled sensitivity of 80% and specificity of 91%.
- The area under the SROC curve was 0.91 for DWI and 0.94 for PWI, indicating comparable diagnostic performance.
Conclusions:
- Both DWI and PWI are effective imaging modalities for differentiating high-grade from low-grade meningiomas.
- Neither technique demonstrated superiority over the other in diagnostic performance for meningioma grading.
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