The diagnostic role of diffusional kurtosis imaging in glioma grading and differentiation of gliomas from other intra-axial brain tumours: a systematic review with critical appraisal and meta-analysis

Abdalla, Gehad; Dixon, Luke; Sanverdi, Eser; Machado, Pedro M.; Kwong, Joey S. W.; Panovska-Griffiths, Jasmina; Rojas-Garcia, Antonio; Yoneoka, Daisuke; Veraart, Jelle; Van Cauter, Sofie; Abdel-Khalek, Ahmed M.; Settein, Magdy; Yousry, Tarek; Bisdas, Sotirios

doi:10.1007/S00234-020-02425-9

Title

The diagnostic role of diffusional kurtosis imaging in glioma grading and differentiation of gliomas from other intra-axial brain tumours: a systematic review with critical appraisal and meta-analysis

Author

Abdalla, Gehad

Dixon, Luke

Sanverdi, Eser

Machado, Pedro M.

Kwong, Joey S. W.

Panovska-Griffiths, Jasmina

Rojas-Garcia, Antonio

Yoneoka, Daisuke

Veraart, Jelle

Van Cauter, Sofie

Abdel-Khalek, Ahmed M.

Settein, Magdy

Yousry, Tarek

Bisdas, Sotirios

Abstract

Purpose We aim to illustrate the diagnostic performance of diffusional kurtosis imaging (DKI) in the diagnosis of gliomas. Methods A review protocol was developed according to the (PRISMA-P) checklist, registered in the international prospective register of systematic reviews (PROSPERO) and published. A literature search in 4 databases was performed using the keywords 'glioma' and 'diffusional kurtosis'. After applying a robust inclusion/exclusion criteria, included articles were independently evaluated according to the QUADAS-2 tool and data extraction was done. Reported sensitivities and specificities were used to construct 2 x 2 tables and paired forest plots using the Review Manager (RevMan (R)) software. A random-effect model was pursued using the hierarchical summary receiver operator characteristics. Results A total of 216 hits were retrieved. Considering duplicates and inclusion criteria, 23 articles were eligible for full-text reading. Ultimately, 19 studies were eligible for final inclusion. The quality assessment revealed 9 studies with low risk of bias in the 4 domains. Using a bivariate random-effect model for data synthesis, summary ROC curve showed a pooled area under the curve (AUC) of 0.92 and estimated sensitivity of 0.87 (95% CI 0.78-0.92) in high-/low-grade gliomas' differentiation. A mean difference in mean kurtosis (MK) value between HGG and LGG of 0.22 (95% CI 0.25-0.19) was illustrated (p value = 0.0014) with moderate heterogeneity (I-2 = 73.8%). Conclusion DKI shows good diagnostic accuracy in the differentiation of high- and low-grade gliomas further supporting its potential role in clinical practice. Further exploration of DKI in differentiating IDH status and in characterising non-glioma CNS tumours is however needed.

Language

English

Source (journal)

Neuroradiology. - Berlin, 1970, currens

Publication

New york : Springer , 2020

ISSN

0028-3940 [print]

1432-1920 [online]

DOI

10.1007/S00234-020-02425-9

Volume/pages