Comparing amide proton transfer imaging with dynamic susceptibility contrast-enhanced perfusion in predicting histological grades of gliomas: a meta-analysis

Abstract

Background As a subtype of chemical exchange saturation transfer imaging without contrast agent administration, amide proton transfer (APT) imaging has demonstrated the potential for differentiating the histologic grades of gliomas. Dynamic susceptibility contrast-enhanced perfusion, a perfusion-weighted imaging technique, is a well-established technique in grading gliomas. Purpose To compare the ability of amide proton transfer and dynamic susceptibility contrast-enhanced imaging for predicting the grades of gliomas. Material and Methods A comprehensive literature search was performed independently by two observers to identify articles about the diagnostic performance of amide proton transfer and dynamic susceptibility contrast-enhanced perfusion in predicting the grade of gliomas. Summary estimates of diagnostic accuracy were obtained by using a random-effects model. Results Of 179 studies identified, 23 studies were included the analysis. Eight studies evaluated amide proton transfer and 16 studies evaluated dynamic susceptibility contrast-enhanced perfusion with the parameter rCBV. The pooled sensitivities and specificities of each study’s best performing parameter were 88% (95% confidence interval [CI] 74–95) and 89% (95% CI 78–95) for amide proton transfer, and 95% (95% CI 87–98), 88% (95% CI 81–93) for perfusion-weighted imaging–dynamic susceptibility contrast-enhanced perfusion, respectively. The pooled sensitivities and specificities for grading gliomas using the two most commonly evaluated parameters, were 92% (95% CI 80–97) and 90% (95% CI 75–96) for APTmax, and 97% (95% CI 91–99) and 87% (95% CI 80–92) for rCBVmax, respectively. Conclusion Considering the similar performance of APT and dynamic susceptibility contrast-enhanced (DSC) in predicting glioma grade, the former method appears preferable since it needs no contrast agent.

The role of APT imaging in gliomas grading: A systematic review and meta-analysis

“…Similar meta-analyses have also highlighted the ability of APT to grade gliomas [40][41][42]. The novelty of our manuscript stems from the comprehensive meta-regression which aimed to characterize imaging protocol considerations to discriminate LGGs from HGGs, grade 2 from grade 3, grade 2 from grade 4, and grade 3 from grade 4…”

Synthetic MRI for Evaluation of Brain Gliomas Grade and Tumor Proliferative Activity：A Retrospective Study

“…In our study, T1 relaxation time was helpful to differentiate HGGs and LGGs and to predict tumor proliferative activity. The gold standard for gliomas grade and tumor proliferative activity is based on surgical removal or biopsy, however, due to the tumor heterogeneity, the pathological results can only re ect the grading and proliferative activity of the specimens taken, rather than the whole tumor [8,22].Therefore,T1 relaxation time, which was associated with gliomas grading and Ki-67 LI, may be useful to provide more information for biopsy ,as well as to determine the range of radiation exposure eld for radiotherapy.…”

“…The intratumoral histological heterogeneity in gliomas can re ect tumor grading [21]. Histologically, HGGs are different from LGGs in respect of nuclear anaplasia, mitoses, cellularity, neovascularization, and necrosis [22]. Some MRI techniques have been reported to help quantify the features of gliomas.…”