Differentiation Between High-Grade Glioma and Brain Metastasis Using Cerebral Perfusion-Related Parameters (Cerebral Blood Volume and Cerebral Blood Flow): A Systematic Review and Meta-Analysis of Perfusion-weighted MRI Techniques

IF 3.3 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Magnetic Resonance Imaging Pub Date : 2024-06-20 DOI:10.1002/jmri.29473

Sana Mohammadi MD, Sadegh Ghaderi PhD, Ali Fathi Jouzdani MD, Iman Azinkhah MSc, Sanaz Alibabaei MSc, Mobin Azami MD, Vida Omrani MSc

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引用次数: 0

Abstract

Background

Distinguishing high-grade gliomas (HGGs) from brain metastases (BMs) using perfusion-weighted imaging (PWI) remains challenging. PWI offers quantitative measurements of cerebral blood flow (CBF) and cerebral blood volume (CBV), but optimal PWI parameters for differentiation are unclear.

Purpose

To compare CBF and CBV derived from PWIs in HGGs and BMs, and to identify the most effective PWI parameters and techniques for differentiation.

Study Type

Systematic review and meta-analysis.

Population

Twenty-four studies compared CBF and CBV between HGGs (n = 704) and BMs (n = 488).

Field Strength/Sequence

Arterial spin labeling (ASL), dynamic susceptibility contrast (DSC), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast-enhanced (DSCE) sequences at 1.5 T and 3.0 T.

Assessment

Following the PRISMA guidelines, four major databases were searched from 2000 to 2024 for studies evaluating CBF or CBV using PWI in HGGs and BMs.

Statistical Tests

Standardized mean difference (SMD) with 95% CIs was used. Risk of bias (ROB) and publication bias were assessed, and I² statistic was used to assess statistical heterogeneity. A P-value<0.05 was considered significant.

Results

HGGs showed a significant modest increase in CBF (SMD = 0.37, 95% CI: 0.05–0.69) and CBV (SMD = 0.26, 95% CI: 0.01–0.51) compared with BMs. Subgroup analysis based on region, sequence, ROB, and field strength for CBF (HGGs: 375 and BMs: 222) and CBV (HGGs: 493 and BMs: 378) values were conducted. ASL showed a considerable moderate increase (50% overlapping CI) in CBF for HGGs compared with BMs. However, no significant difference was found between ASL and DSC (P = 0.08).

Data Conclusion

ASL-derived CBF may be more useful than DSC-derived CBF in differentiating HGGs from BMs. This suggests that ASL may be used as an alternative to DSC when contrast medium is contraindicated or when intravenous injection is not feasible.

Level of Evidence

Technical Efficacy

Stage 2.

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利用脑灌注相关参数（脑血容量和脑血流量）区分高级别胶质瘤和脑转移瘤：灌注加权磁共振成像技术的系统性回顾和元分析》。

背景：利用灌注加权成像（PWI）区分高级别胶质瘤（HGGs）和脑转移瘤（BMs）仍具有挑战性。PWI可定量测量脑血流（CBF）和脑血容量（CBV），但用于区分的最佳PWI参数尚不明确。目的：比较HGGs和BMs的PWI得出的CBF和CBV，确定最有效的PWI参数和区分技术：研究类型：系统回顾和荟萃分析：24项研究比较了HGG（n = 704）和BM（n = 488）的CBF和CBV：场强/序列：动脉自旋标记（ASL）、动态感性对比（DSC）、动态对比增强（DCE）和动态感性对比增强（DSCE）序列，频率为1.5 T和3.0 T：按照PRISMA指南，检索了2000年至2024年四个主要数据库中使用脉搏波速度成像评估HGG和BM的CBF或CBV的研究：统计检验：采用标准化平均差（SMD）和 95% CIs。评估了偏倚风险（ROB）和发表偏倚，并使用 I2 统计量评估了统计异质性。P值结果：与 BMs 相比，HGGs 的 CBF（SMD = 0.37，95% CI：0.05-0.69）和 CBV（SMD = 0.26，95% CI：0.01-0.51）有明显的适度增加。根据CBF（HGGs：375和BMs：222）和CBV（HGGs：493和BMs：378）值的区域、序列、ROB和场强进行了亚组分析。ASL 显示，与 BMs 相比，HGGs 的 CBF 有相当程度的中度增加（50% 重叠 CI）。然而，ASL 和 DSC 之间没有发现明显差异（P = 0.08）：数据结论：在区分 HGG 和 BMs 方面，ASL 导出的 CBF 可能比 DSC 导出的 CBF 更有用。这表明，当造影剂禁忌或无法进行静脉注射时，ASL可作为DSC的替代方法：1：技术疗效：证据级别：1：技术疗效：第 2 阶段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Magnetic Resonance Imaging 医学-核医学

CiteScore

9.70

自引率

6.80%

发文量

494

审稿时长

2 months

期刊介绍： The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.