RT Journal Article
SR Electronic
T1 Pretreatment ADC Histogram Analysis as a Prognostic Imaging Biomarker for Patients with Recurrent Glioblastoma Treated with Bevacizumab: A Systematic Review and Meta-analysis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 202
OP 206
DO 10.3174/ajnr.A7406
VO 43
IS 2
A1 R. Kurokawa
A1 A. Baba
A1 M. Kurokawa
A1 A. Capizzano
A1 O. Hassan
A1 T. Johnson
A1 Y. Ota
A1 J. Kim
A1 A. Hagiwara
A1 T. Moritani
A1 A. Srinivasan
YR 2022
UL http://www.ajnr.org/content/43/2/202.abstract
AB BACKGROUND: The mean ADC value of the lower Gaussian curve (ADCL) derived from the bi-Gaussian curve-fitting histogram analysis has been reported as a predictive/prognostic imaging biomarker in patients with recurrent glioblastoma treated with bevacizumab; however, its systematic summary has been lacking.PURPOSE: We applied a systematic review and meta-analysis to investigate the predictive/prognostic performance of ADCL in patients with recurrent glioblastoma treated with bevacizumab.DATA SOURCES: We performed a literature search using PubMed, Scopus, and EMBASE.STUDY SELECTION: A total of 1344 abstracts were screened, of which 83 articles were considered potentially relevant. Data were finally extracted from 6 studies including 578 patients.DATA ANALYSIS: Forest plots were generated to illustrate the hazard ratios of overall survival and progression-free survival. The heterogeneity across the studies was assessed using the Cochrane Q test and I2 values.DATA SYNTHESIS: The pooled hazard ratios for overall survival and progression-free survival in patients with an ADCL lower than the cutoff values were 1.89 (95% CI, 1.53–2.31) and 1.98 (95% CI, 1.54–2.55) with low heterogeneity among the studies. Subgroup analysis of the bevacizumab-free cohort showed a pooled hazard ratio for overall survival of 1.20 (95% CI, 1.08–1.34) with low heterogeneity.LIMITATIONS: The conclusions are limited by the difference in the definition of recurrence among the included studies.CONCLUSIONS: This systematic review with meta-analysis supports the prognostic value of ADCL in patients with recurrent glioblastoma treated with bevacizumab, with a low ADCL demonstrating decreased overall survival and progression-free survival. On the other hand, the predictive role of ADCL for bevacizumab treatment was not confirmed.ADCLmean ADC value of the lower Gaussian curveHRhazard ratioOSoverall survivalPFSprogression-free survivalQUADAS-2Quality Assessment of Diagnostic Accuracy Studies 2VEGFvascular endothelial growth factor