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Differentiating Glioma from Brain Metastasis Using Neurite Orientation Dispersion and Density Imaging: A Systematic
Amir Mahmoud Ahmadzadeh1, Nima Broomand Lomer2, Sadegh Ghaderi3,4
1From the Department of Radiology, School of Medicine (A.M.A.), Mashhad University of Medical Sciences, Mashhad, Iran.
Background:
Differentiation between gliomas and brain metastases (BMs) remains a diagnostic challenge. Noninvasive imaging biomarkers could be advantageous in brain tumor discrimination.
Purpose:
We aimed to systematically review the studies that measured neurite orientation dispersion and density imaging (NODDI) parameters in patients with gliomas and BMs.
Data Sources:
A literature search was conducted in 4 databases, including PubMed, Web of Science, EMBASE, and Scopus.
Study Selection:
Studies that measured NODDI parameters, such as intracellular volume fraction (V-IC), isotropic volume fraction (V-ISO), and orientation dispersion index (ODI) in both patients with glioma and patients with BM were included.
Data Analysis:
Quality was assessed using the modified Newcastle-Ottawa Scale checklist. Pooled standardized mean differences (SMDs) with corresponding 95% CIs were calculated using a random-effects model. Heterogeneity was evaluated using the I 2 statistic. Subgroup analysis was performed to explore sources of heterogeneity. Funnel plots, along with Begg and Egger tests were applied to investigate publication bias.
Data Synthesis:
Ten studies were ultimately included in the systematic review. We found significant SMDs for ODI (SMD = -1.43 [-2.02, -0.85]) and V-ISO (SMD = -0.98 [-1.60, -0.37]) between gliomas and BMs in the contrast-enhancing region. Also, for the glioblastoma subgroup, V-ISO of the peritumoral edema area showed a significant SMD (SMD = -0.73 [-0.96, -0.50]). No significant differences were found for other parameters. The heterogeneity turned from high to low in specific subgroups, including the glioblastoma subgroup.
Limitations:
Our meta-analysis is limited by small number of studies.
Conclusions:
NODDI parameters, particularly ODI and V-ISO, can be considered useful tools for differentiating gliomas from BMs. These findings highlight the potential of NODDI as a noninvasive imaging biomarker to improve the differential diagnosis of intracranial tumors.
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