@article {Suh1208, author = {C.H. Suh and H.S. Kim and S.C. Jung and S.J. Kim}, title = {Diffusion-Weighted Imaging and Diffusion Tensor Imaging for Differentiating High-Grade Glioma from Solitary Brain Metastasis: A Systematic Review and Meta-Analysis}, volume = {39}, number = {7}, pages = {1208--1214}, year = {2018}, doi = {10.3174/ajnr.A5650}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND: Accurate diagnosis of high-grade glioma and solitary brain metastasis is clinically important because it affects the patient{\textquoteright}s outcome and alters patient management.PURPOSE: To evaluate the diagnostic performance of DWI and DTI for differentiating high-grade glioma from solitary brain metastasis.DATA SOURCES: A literature search of Ovid MEDLINE and EMBASE was conducted up to November 10, 2017.STUDY SELECTION: Studies evaluating the diagnostic performance of DWI and DTI for differentiating high-grade glioma from solitary brain metastasis were selected.DATA ANALYSIS: Summary sensitivity and specificity were established by hierarchic logistic regression modeling. Multiple subgroup analyses were also performed.DATA SYNTHESIS: Fourteen studies with 1143 patients were included. The individual sensitivities and specificities of the 14 included studies showed a wide variation, ranging from 46.2\% to 96.0\% for sensitivity and 40.0\% to 100.0\% for specificity. The pooled sensitivity of both DWI and DTI was 79.8\% (95\% CI, 70.9\%{\textendash}86.4\%), and the pooled specificity was 80.9\% (95\% CI, 75.1\%{\textendash}85.5\%). The area under the hierarchical summary receiver operating characteristic curve was 0.87 (95\% CI, 0.84{\textendash}0.89). The multiple subgroup analyses also demonstrated similar diagnostic performances (sensitivities of 76.8\%{\textendash}84.7\% and specificities of 79.7\%{\textendash}84.0\%). There was some level of heterogeneity across the included studies (I2 = 36\%); however, it did not reach a level of concern.LIMITATIONS: The included studies used various DWI and DTI parameters.CONCLUSIONS: DWI and DTI demonstrated a moderate diagnostic performance for differentiation of high-grade glioma from solitary brain metastasis.FAfractional anisotropyHSROChierarchic summary receiver operating characteristicMDmean diffusivityPRISMAPreferred Reporting Items for Systematic Reviews and Meta-AnalysesQUADAS-2Quality Assessment of Diagnostic Accuracy Studies-2}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/39/7/1208}, eprint = {https://www.ajnr.org/content/39/7/1208.full.pdf}, journal = {American Journal of Neuroradiology} }