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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Meta-analysis of arterial spin labeling MRI to identify residual cerebral arteriovenous malformations after treatment
Shurun Wan1, Xiuyan Yang2, Yudi Zhuo1
1Key Laboratory of Chinese Internal Medicine of Educational Ministry and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
Background:
To use of statistical methods to assess the diagnostic value of arterial spin labeling (ASL) imaging for follow-up of treated arteriovenous malformations.
Methods:
We screened references from four databases, namely, the Cochrane Library, PubMed, Web of Science and Embase, that met the requirements. The methodology quality of the included studies was evaluated using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) tool. Data pertaining to diagnostic performance were extracted, and the pooled sensitivity and specificity were calculated using a bivariate mixed-effects model.
Results:
We included six studies with a total of 132 patients with arteriovenous malformation (AVM). The merged sensitivity and specificity of ASL for the diagnosis of brain AVMs with incomplete occlusion after treatment were 0.94[0.86-0.98] and 0.99 [0.59-1.00], respectively. According to the SROC curve summary, the AUC was found to be 0.98 [0.96-0.99]. No significant publication bias was observed.
Conclusion:
While ASL does not currently match the diagnostic precision of DSA, it is instrumental in post-treatment surveillance of AVM patients. With the development of ASL technology in the future, this technique holds promise as a minimally invasive diagnostic strategy for AVMs with fewer side effects.
Registration Number Of Prospero:
CRD42023422087.
Clinical Trial Number:
Not applicable.
Insights
Arterial spin labeling (ASL) shows high diagnostic accuracy for monitoring treated arteriovenous malformations (AVMs), proving valuable for post-treatment surveillance. Future developments may establish ASL as a minimally invasive diagnostic tool for AVMs.
Area of Science:
- Medical Imaging
- Diagnostic Accuracy
- Neurology
Background:
- Arteriovenous malformations (AVMs) require effective follow-up after treatment.
- Arterial spin labeling (ASL) is an emerging imaging technique.
- Assessing the diagnostic utility of ASL in AVM management is crucial.
Purpose of the Study:
- To statistically evaluate the diagnostic performance of ASL imaging.
- To assess ASL's role in the follow-up of treated arteriovenous malformations.
Main Methods:
- Systematic literature search across Cochrane Library, PubMed, Web of Science, and Embase.
- Quality assessment of included studies using the QUADAS-2 tool.
- Meta-analysis of diagnostic accuracy data using a bivariate mixed-effects model.
Main Results:
- Six studies with 132 patients were included.
- Pooled sensitivity and specificity for ASL in detecting incomplete AVM occlusion were 0.94 and 0.99, respectively.
- Summary ROC curve analysis yielded an AUC of 0.98, indicating high diagnostic performance.
Conclusions:
- ASL demonstrates significant diagnostic value in post-treatment surveillance of AVM patients.
- While not yet matching DSA precision, ASL is instrumental for AVM follow-up.
- Advancements in ASL technology promise a minimally invasive diagnostic strategy for AVMs with fewer side effects.
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