The diagnostic value of intravoxel incoherent motion imaging in differentiating high-grade from low-grade gliomas: a systematic review and meta-analysis

Abstract

Objective: This meta-analysis was carried out for assessing the accuracy of intravoxel incoherent motion (IVIM) parameters true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) in differentiating low-grade gliomas (LGGs) from high-grade gliomas (HGGs). Methods: Literatures concerning IVIM in the grading of brain gliomas published prior to October 20, 2020, searched in the Embase, PubMed, and Cochrane library. Use the quality assessment of diagnostic accuracy studies 2 (QUADAS 2) to evaluate the quality of studies. We estimated the pooled sensitivity, specificity, and the area under the summary ROC (SROC) curve to identification the accuracy of IVIM parameters D, D*, and f evaluation in grading gliomas. Results: Totally, 6 articles including 252 brain gliomas conform to the inclusion criteria. The pooled sensitivity of parameters D, D*, and f derived from IVIM were 0.85 (95%Cl, 0.76–0.91), 0.78 (95%Cl, 0.71–0.85), and 0.89 (95%Cl, 0.76–0.96), respectively. The pooled specificity were 0.78 (95%Cl, 0.60–0.90), 0.68 (95%Cl, 0.56–0.79), and 0.88 (95%Cl, 0.76–0.94), respectively. Meanwhile, the AUC of SROC curve were 0.89 (95%Cl, 0.86–0.92) , 0.81 (95%Cl, 0.77–0.84), and 0.94 (95%Cl, 0.92–0.96), respectively. Conclusion: This meta-analysis suggested that IVIM parameters D, D*, and f have moderate or high diagnosis value accuracy in differentiating HGGs from LGGs, and the parameter f has greater sensitivity and specificity. Standardized methodology is warranted to guide the use of this method for clinical decision-making. However, more clinical studies are needed to prove our view. Advances in knowledge: IVIM parameter f showed greater sensitivity and specificity, as well as excellent performance than parameter D* and D.

The imaging principle of IVIM and its value in the diagnosis and treatment of ischemic stroke

“…IVIM can also assist BOLD in imaging and provide higher resolution, mainly because IVIM is more sensitive to capillary blood flow than BOLD Published by Francis Academic Press, UK -14- [15,27] . IVIM is also widely used in the classification of breast cancer [28][29][30] and the differentiation of high and low grade gliomas [31][32][33][34] .…”