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Research ArticleAdult Brain

Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis

N. Verburg, F.W.A. Hoefnagels, F. Barkhof, R. Boellaard, S. Goldman, J. Guo, J.J. Heimans, O.S. Hoekstra, R. Jain, M. Kinoshita, P.J.W. Pouwels, S.J. Price, J.C. Reijneveld, A. Stadlbauer, W.P. Vandertop, P. Wesseling, A.H. Zwinderman and P.C. De Witt Hamer
American Journal of Neuroradiology October 2017, 38 (10) 1884-1891; DOI: https://doi.org/10.3174/ajnr.A5368
N. Verburg
aFrom the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.)
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F.W.A. Hoefnagels
aFrom the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.)
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F. Barkhof
bDepartments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.)
nInstitutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.
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R. Boellaard
bDepartments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.)
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S. Goldman
fService of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium
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J. Guo
gShanghai Medical College (J.G.), Fudan University, Shanghai, China
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J.J. Heimans
cNeurology (J.J.H., J.C.R.)
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O.S. Hoekstra
bDepartments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.)
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R. Jain
hDepartment of Radiology (R.J.), New York University School of Medicine, New York, New York
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M. Kinoshita
iDepartment of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan
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P.J.W. Pouwels
dPhysics and Medical Technology (P.J.W.P.)
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S.J. Price
jAcademic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK
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J.C. Reijneveld
cNeurology (J.J.H., J.C.R.)
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A. Stadlbauer
kDepartment of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany
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W.P. Vandertop
aFrom the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.)
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P. Wesseling
ePathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands
lDepartment of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands
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A.H. Zwinderman
mDepartment of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands
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P.C. De Witt Hamer
aFrom the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.)
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    Fig 1.

    Flow chart of publication selection. The asterisk indicates that multiple exclusion criteria could apply to studies.

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    Fig 2.

    Number of publications, patients, and samples for imaging techniques categorized by glioma grades. LGG indicates low-grade glioma; HGG, high-grade glioma; FLT, 18F fluorthymidine; nr, number.

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    Fig 3.

    Summary hierarchic ROC curves of imaging techniques. Estimated summary ROC curves are plotted by imaging technique in ROC space for diffuse gliomas as a whole—that is, low- and high-grade gliomas combined (A), low-grade glioma (B), and high-grade glioma (C). The operating points of curves represent the estimated summary true-positive and false-positive rates as indicated by solid squares. Solid squares are missing when convergence is not reached. Color coding shows conventional MR imaging in black, advanced MR imaging in shades of blue, PET imaging in shades of red, and CT and sonography imaging in shades of green.

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    Fig 4.

    Diagnostic accuracy characteristics of imaging techniques. Diagnostic performance of imaging techniques expressed as area under the curve, summary false-positive rate, summary true-positive rate, and diagnostic odds ratio for diffuse gliomas as a whole—that is, low- and high-grade gliomas combined (A), low-grade glioma (B), and high-grade glioma (C). The medians of posterior distributions are plotted as squares proportional to the number of observations with 95% credibility intervals. The most common clinically used imaging technique is in blue as reference. n.a. indicates nonavailable data because either <3 studies were available or the posterior samples did not converge; fa, fractional anisotropy.

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American Journal of Neuroradiology: 38 (10)
American Journal of Neuroradiology
Vol. 38, Issue 10
1 Oct 2017
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Cite this article
N. Verburg, F.W.A. Hoefnagels, F. Barkhof, R. Boellaard, S. Goldman, J. Guo, J.J. Heimans, O.S. Hoekstra, R. Jain, M. Kinoshita, P.J.W. Pouwels, S.J. Price, J.C. Reijneveld, A. Stadlbauer, W.P. Vandertop, P. Wesseling, A.H. Zwinderman, P.C. De Witt Hamer
Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis
American Journal of Neuroradiology Oct 2017, 38 (10) 1884-1891; DOI: 10.3174/ajnr.A5368

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Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis
N. Verburg, F.W.A. Hoefnagels, F. Barkhof, R. Boellaard, S. Goldman, J. Guo, J.J. Heimans, O.S. Hoekstra, R. Jain, M. Kinoshita, P.J.W. Pouwels, S.J. Price, J.C. Reijneveld, A. Stadlbauer, W.P. Vandertop, P. Wesseling, A.H. Zwinderman, P.C. De Witt Hamer
American Journal of Neuroradiology Oct 2017, 38 (10) 1884-1891; DOI: 10.3174/ajnr.A5368
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