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Arterial Spin-Labeling in Children with Brain Tumor: A Meta-Analysis
Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden;Uppsala Univ, Dept Surg Sci, Uppsala, Sweden.
Univ G DAnnunzio, Sch Med & Hlth Sci, Fac Med & Surg, Chieti, Italy.
Karolinska Inst, Dept Neuroradiol, Stockholm, Sweden.
Lund Univ, Fac Med, Clin Sci, Lund, Sweden.
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2018 (English)In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 39, no 8, p. 1536-1542Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:The value of arterial spin-labeling in a pediatric population has not been assessed in a meta-analysis. PURPOSE:Our aim was to assess the diagnostic accuracy of arterial spin-labeling-derived cerebral blood flow to discriminate low- and high-grade tumors. DATA SOURCES:MEDLINE, EMBASE, the Web of Science Core Collection, and the Cochrane Library were used. STUDY SELECTION:Pediatric patients with arterial spin-labeling MR imaging with verified neuropathologic diagnoses were included. DATA ANALYSIS:Relative CBF and absolute CBF and tumor grade were extracted, including sequence-specific information. Mean differences in CBF between low- and high-grade tumors were calculated. Study quality was assessed. DATA SYNTHESIS:Data were aggregated using the bivariate summary receiver operating characteristic curve model. Heterogeneity was explored with meta-regression and subgroup analyses. The study protocol was published at PROSPERO (CRD42017075055). Eight studies encompassing 286 pediatric patients were included. The mean differences in absolute CBF were 29.62 mL/min/100 g (95% CI, 10.43-48.82 mL/min/100 g), I-2 = 74, P = .002, and 1.34 mL/min/100 g (95% CI, 0.95-1.74 mL/min/100 g), P < .001, I-2 = 38 for relative CBF. Pooled sensitivity for relative CBF ranged from 0.75 to 0.90, and specificity, from 0.77 to 0.92 with an area under curve = 0.92. Meta-regression showed no moderating effect of sequence parameters TE, TR, acquisition time, or ROI method. LIMITATIONS:Included tumor types, analysis method, and original data varied among included studies. CONCLUSIONS:Arterial spin-labeling-derived CBF measures showed high diagnostic accuracy for discriminating low- and high-grade tumors in pediatric patients with brain tumors. The relative CBF showed less variation among studies than the absolute CBF.

Place, publisher, year, edition, pages
AMER SOC NEURORADIOLOGY , 2018. Vol. 39, no 8, p. 1536-1542
National Category
Radiology, Nuclear Medicine and Medical Imaging
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URN: urn:nbn:se:uu:diva-369527DOI: 10.3174/ajnr.A5727ISI: 000441271400032PubMedID: 30072368OAI: oai:DiVA.org:uu-369527DiVA, id: diva2:1271279
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2018-12-17Bibliographically approved

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