Diagnostic Values of DCE-MRI and DSC-MRI for Differentiation Between High-grade and Low-grade Gliomas: A Comprehensive Meta-analysis

Rationale and Objectives: This study aimed to collect the studies on the role of dynamic contrast-enhanced magnetic resonance imaging I (DCE-MRI) and dynamic susceptibility contrast MRI (DSC-MRI) in differentiating the grades of gliomas, and evaluate the diagnostic performances of relevant quantitative parameters in glioma grading. Materials and Methods: We systematically searched studies on the diagnosis of gliomas with DCE-MRI or DSC-MRI in Medline, PubMed, China National Knowledge Infrastructure database, Cochrane Library, and Embase published between January 2005 and December 2016. Standardized mean differences and 95% confidence intervals were calculated for volume transfer coefficient (K-trans) volume fraction of extravascular extracellular space (v(e)), rate constant of backflux (K-ep), relative cerebral blood volume (rCBV), and relative cerebral blood flow (rCBF) using Review Manager 5.2 software. Sensitivity, specificity, area under the curve (AUC), and Begg test were calculated by Stata 12.0. Results: Twenty-two studies with available outcome data were included in the analysis. The standardized mean difference of K-trans values between high-grade glioma and low-grade glioma were 1.18 (0.91, 1.45); V-e values were 1.43 (1.06, 1.80); K-ep values were 0.65 (-0.05, 1.36); rCBV values were 1.44 (1.08, 1.81); and rCBF values were 1.17 (0.68, 1.67), respectively. The results were all significant statistically (P <.05) except K-ep values (P =.07), and high-grade glioma had higher K-trans, V-e, rCBV, and rCBF values than low-grade glioma. AUC values of K-trans, V-e, rCBV, and rCBF were 0.90, 0.88, 0.93, and 0.73, respectively; rCBV had the largest AUC among the four parameters (P <.05). Conclusion: Both DCE-MRI and DSC-MRI are reliable techniques in differentiating the grades of gliomas, and rCBV was found to be the most sensitive one.