PT  - JOURNAL ARTICLE
AU  - C.H. Suh
AU  - H.S. Kim
AU  - S.C. Jung
AU  - S.J. Kim
TI  - Diffusion-Weighted Imaging and Diffusion Tensor Imaging for Differentiating High-Grade Glioma from Solitary Brain Metastasis: A Systematic Review and Meta-Analysis
AID  - 10.3174/ajnr.A5650
DP  - 2018 Jul 01
TA  - American Journal of Neuroradiology
PG  - 1208--1214
VI  - 39
IP  - 7
4099  - http://www.ajnr.org/content/39/7/1208.short
4100  - http://www.ajnr.org/content/39/7/1208.full
SO  - Am. J. Neuroradiol.2018 Jul 01; 39
AB  - BACKGROUND: Accurate diagnosis of high-grade glioma and solitary brain metastasis is clinically important because it affects the patient'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%–86.4%), and the pooled specificity was 80.9% (95% CI, 75.1%–85.5%). The area under the hierarchical summary receiver operating characteristic curve was 0.87 (95% CI, 0.84–0.89). The multiple subgroup analyses also demonstrated similar diagnostic performances (sensitivities of 76.8%–84.7% and specificities of 79.7%–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