Article Figures & Data
Figures
- Fig 1.
Flowchart depicting the literature search and study selection.
- Fig 2.
Grouped bar charts indicating methodologic quality according to the QUADAS-2 criteria and expressed as the percentage of studies meeting each criterion. For each quality domain, the proportions of studies suggesting a low, high, or unclear risk of bias and/or concerns regarding applicability are illustrated in green, red, and blue, respectively.
- Fig 3.
Coupled forest plots showing the diagnostic performance of each study. Vertical lines in the coupled forest plots show the pooled sensitivity and specificity.
- Fig 4.
Hierarchical summary receiver operating characteristic curve with 95% confidence and prediction regions of DWI for differentiating metastatic LNs from benign LNs in patients with HNSCC. Each circle indicates 1 included study.
- Fig 5.
The Deeks funnel plot showing the presence of publication bias. Numbers in circles refer to study number. ESS indicates effective sample size.
Tables
Metaregression results
Covariates Subgroups Pooled Sensitivity (95% CI) P Value Pooled Specificity (95% CI) P Value Analysis method Per LN 89% (84%–94%) .42 87% (80–93%) .43 Per patient 95% (85%–100%) 97% (89–100%) Percentage of metastatic LN <36.7% 86% (78%–94%) .20 86% (77–95%) .25 ≥36.7% 92% (88%–97%) 89% (81%–97%) Underlying disease HNSCC 91% (86%–96%) .29 88% (81%–95%) .37 Oral SCC 87% (76%–97%) 86% (74%–99%) Study design Prospective 91% (86%–96%) .74 89% (84%–94%) .15 Retrospective 85% (64%–100%) 68% (24%–100%) Consecutive enrollment Yes 92% (87%–96%) .30 91% (89%–94%) .92 No 86% (76%–96%) 68% (56%–80%) No. of readers 2 90% (84%–95%) .42 87% (80%–94%) .53 1 89% (76%–100%) 85% (70%–100%) Magnetic field strength 3T 92% (86%–98%) .12 87% (79%–96%) .11 1.5T 89% (82%–95%) 88% (80%–96%) Maximum b-value <1000 88% (79%–96%) .16 86% (76%–97%) .27 1000 91% (86%–97%) 89% (82%–96%) Slice thickness 3 mm 93% (88%–98%) <.01 86% (78%–94%) .49 >3 mm 86% (77%–95%) 93% (88%–99%) ADC measurement Whole node 93% (89%–97%) .19 89% (82%–97%) .28 Single section 86% (79%–94%) 86% (76%–95%) Note:—ADC indicates apparent diffusion coefficient; HNSCC, head and neck squamous cell carcinoma; LN, lymph node; SCC, squamous cell carcinoma.
