Diagnostic Accuracy of SPECT for Mild Traumatic Brain Injury: A Systematic Review and Meta-analysis.

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Mild traumatic brain injury (mTBI) poses diagnostic challenges.
• Brain perfusion single-photon emission computed tomography (SPECT) is explored for its potential in diagnosing mTBI.
• Accurate diagnostic tools are crucial for effective mTBI management.

Purpose of the Study:

• To systematically review and meta-analyze the diagnostic accuracy of brain perfusion SPECT for mTBI.
• To determine the prevalence of hypoperfusion abnormalities in mTBI patients using SPECT.
• To assess the added value of brain perfusion SPECT in mTBI detection.

Main Methods:

• Systematic review and meta-analysis following PRISMA guidelines.
• Searched five databases for studies on adult mTBI patients (GCS 13-15) using brain perfusion SPECT.
• Assessed study quality with a modified QUADAS-2 tool and pooled hypoperfusion proportions by brain lobe.

Main Results:

• Included 22 studies (800 patients); frontal lobe hypoperfusion was most common (40.1%), followed by the temporal lobe (26.1%).
• SPECT detected abnormalities not visible on MRI and correlated with neuropsychological findings.
• Evidence for sensitivity and specificity was limited, rated as low quality (GRADE).

Conclusions:

• Perfusion abnormalities, especially in frontal and temporal lobes, are observed in mTBI patients via SPECT but are nonspecific.
• Brain perfusion SPECT offers additional information for mTBI assessment.
• The definitive added value of brain perfusion SPECT for mTBI detection is currently unknown.