Amide proton transfer-weighted MRI in distinguishing high- and low-grade gliomas: a systematic review and meta-analysis

2019 ◽  
Vol 61 (5) ◽  
pp. 525-534 ◽  
Author(s):  
Chong Hyun Suh ◽  
Ji Eun Park ◽  
Seung Chai Jung ◽  
Choong Gon Choi ◽  
Sang Joon Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Proton Transfer ◽  
Meta Analysis ◽  
Amide Proton ◽  
Low Grade ◽  
Low Grade Gliomas ◽  
Amide Proton Transfer

scholarly journals Amide proton transfer weighted (APTw) imaging based radiomics allows for the differentiation of gliomas from metastases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Elisabeth Sartoretti ◽  
Thomas Sartoretti ◽  
Michael Wyss ◽  
Carolin Reischauer ◽  
Luuk van Smoorenburg ◽  
...  
Keyword(s):  
Machine Learning ◽  
Random Forest ◽  
Brain Tumors ◽  
Proton Transfer ◽  
Multilayer Perceptron ◽  
Random Forest Classifier ◽  
Amide Proton ◽  
Low Grade ◽  
Who Grade ◽  
Amide Proton Transfer

AbstractWe sought to evaluate the utility of radiomics for Amide Proton Transfer weighted (APTw) imaging by assessing its value in differentiating brain metastases from high- and low grade glial brain tumors. We retrospectively identified 48 treatment-naïve patients (10 WHO grade 2, 1 WHO grade 3, 10 WHO grade 4 primary glial brain tumors and 27 metastases) with either primary glial brain tumors or metastases who had undergone APTw MR imaging. After image analysis with radiomics feature extraction and post-processing, machine learning algorithms (multilayer perceptron machine learning algorithm; random forest classifier) with stratified tenfold cross validation were trained on features and were used to differentiate the brain neoplasms. The multilayer perceptron achieved an AUC of 0.836 (receiver operating characteristic curve) in differentiating primary glial brain tumors from metastases. The random forest classifier achieved an AUC of 0.868 in differentiating WHO grade 4 from WHO grade 2/3 primary glial brain tumors. For the differentiation of WHO grade 4 tumors from grade 2/3 tumors and metastases an average AUC of 0.797 was achieved. Our results indicate that the use of radiomics for APTw imaging is feasible and the differentiation of primary glial brain tumors from metastases is achievable with a high degree of accuracy.

scholarly journals Management of low-grade glioma: a systematic review and meta-analysis

2018 ◽  
Vol 6 (4) ◽  
pp. 249-258 ◽  
Author(s):  
Timothy J Brown ◽  
Daniela A Bota ◽  
Martin J van Den Bent ◽  
Paul D Brown ◽  
Elizabeth Maher ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Low Grade Glioma ◽  
World Health ◽  
Subtotal Resection ◽  
Low Grade ◽  
Evidence Based ◽  
Free Survival ◽  
Low Grade Gliomas

Abstract Background Optimum management of low-grade gliomas remains controversial, and widespread practice variation exists. This evidence-based meta-analysis evaluates the association of extent of resection, radiation, and chemotherapy with mortality and progression-free survival at 2, 5, and 10 years in patients with low-grade glioma. Methods A quantitative systematic review was performed. Inclusion criteria included controlled trials of newly diagnosed low-grade (World Health Organization Grades I and II) gliomas in adults. Eligible studies were identified, assigned a level of evidence for every endpoint considered, and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality and of progression at 2, 5, and 10 years was calculated for patients undergoing resection (gross total, subtotal, or biopsy), radiation, or chemotherapy. Results Gross total resection was significantly associated with decreased mortality and likelihood of progression at all time points compared to subtotal resection. Early radiation was not associated with decreased mortality; however, progression-free survival was better at 5 years compared to patients receiving delayed or no radiation. Chemotherapy was associated with decreased mortality at 5 and 10 years in the high-quality literature. Progression-free survival was better at 5 and 10 years compared to patients who did not receive chemotherapy. In patients with isocitrate dehydrogenase 1 gene (IDH1) R132H mutations receiving chemotherapy, progression-free survival was better at 2 and 5 years than in patients with IDH1 wild-type gliomas. Conclusions Results from this review, the first to quantify differences in outcome associated with surgery, radiation, and chemotherapy in patients with low-grade gliomas, can be used to inform evidence-based management and future clinical trials.

scholarly journals The Prevalence of BRAF Mutations in Patients with Glioma: A Systematic Review

2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv13-iv13
Author(s):  
Saanwalshah Samir Saincher ◽  
Julian P T Higgins ◽  
Alexandra McAleenan ◽  
Kathreena M Kurian
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Age Groups ◽  
Low Grade ◽  
Braf Inhibitors ◽  
Braf Mutations ◽  
Low Grade Gliomas ◽  
Promising Area ◽  
Oncogene Homologue ◽  
Murine Sarcoma

Abstract Background The V600mutation in the v-raf murine sarcoma oncogene homologue B1 (BRAF) enzyme, is a potential clinically actionable target in gliomas. BRAF inhibitors are in wide clinical use for other tumour types, particularly melanoma. The prevalence of this mutation across all gliomas is not fully elucidated and is needed to inform potential screening and treatment. Methods A systematic review using articles on the MEDLINE and EMBASE databases (February 1, 2019) was carried out. A meta-analysis was conducted to calculate the prevalence of BRAF mutations in patients with gliomas across all populations and age groups in a clinical setting. Preliminary Results The review identified 75 studies including 6316 patients; the ages of participants ranged from 30 days to 90 years with a mean age of 32.75 years. Across all studies, the average prevalence of BRAF mutations was 16% (95% confidence interval (CI) from 12% to 20%) but estimates were highly variable across studies, ranging from 0% to 78%. The average prevalence of BRAF mutations in paediatric group was 15% (95% CI 10% to 20%) while the average prevalence in the adult group was 9% (95% CI 4% to 16%). Low grade gliomas had an average prevalence of 19% (95% CI 14% to 25%) compared with 7% (95% CI 4% to 11%) in high-grade gliomas. Conclusions BRAF mutations were found to be more prevalent in pediatric patients and in low grade gliomas. Screening these patients for BRAF mutations and treating them with BRAF inhibitors represents a promising area of future medical practice.

scholarly journals Clinical translation of amide proton transfer (APT) MRI for ischemic stroke: a systematic review (2003–2020)

2021 ◽  
Vol 11 (8) ◽  
pp. 3797-3811
Author(s):  
Lee Sze Foo ◽  
George Harston ◽  
Amit Mehndiratta ◽  
Wun-She Yap ◽  
Yan Chai Hum ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Proton Transfer ◽  
Clinical Translation ◽  
Amide Proton ◽  
Amide Proton Transfer

scholarly journals Assessment of Amide proton transfer weighted (APTw) MRI for pre-surgical prediction of final diagnosis in gliomas

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244003
Author(s):  
Faris Durmo ◽  
Anna Rydhög ◽  
Frederik Testud ◽  
Jimmy Lätt ◽  
Benjamin Schmitt ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Proton Transfer ◽  
High Grade Glioma ◽  
Radiological Diagnosis ◽  
Amide Proton ◽  
Histopathological Diagnosis ◽  
Low Grade ◽  
Tumor Type ◽  
Post Contrast ◽  
Amide Proton Transfer

Purpose Radiological assessment of primary brain neoplasms, both high (HGG) and low grade tumors (LGG), based on contrast-enhancement alone can be inaccurate. We evaluated the radiological value of amide proton transfer weighted (APTw) MRI as an imaging complement for pre-surgical radiological diagnosis of brain tumors. Methods Twenty-six patients were evaluated prospectively; (22 males, 4 females, mean age 55 years, range 26–76 years) underwent MRI at 3T using T1-MPRAGE pre- and post-contrast administration, conventional T2w, FLAIR, and APTw imaging pre-surgically for suspected primary/secondary brain tumor. Assessment of the additional value of APTw imaging compared to conventional MRI for correct pre-surgical brain tumor diagnosis. The initial radiological pre-operative diagnosis was based on the conventional contrast-enhanced MR images. The range, minimum, maximum, and mean APTw signals were evaluated. Conventional normality testing was performed; with boxplots/outliers/skewness/kurtosis and a Shapiro–Wilk’s test. Mann-Whitney U for analysis of significance for mean/max/min and range APTw signal. A logistic regression model was constructed for mean, max, range and Receiver Operating Characteristic (ROC) curves calculated for individual and combined APTw signals Results Conventional radiological diagnosis prior to surgery/biopsy was HGG (8 patients), LGG (12 patients), and metastasis (6 patients). Using the mean and maximum: APTw signal would have changed the pre-operative evaluation the diagnosis in 8 of 22 patients (two LGGs excluded, two METs excluded). Using a cut off value of >2.0% for mean APTw signal integral, 4 of the 12 radiologically suspected LGG would have been diagnosed as high grade glioma, which was confirmed by histopathological diagnosis. APTw mean of >2.0% and max >2.48% outperformed four separate clinical radiological assessments of tumor type, P-values = .004 and = .002, respectively. Conclusions Using APTw-images as part of the daily clinical pre-operative radiological evaluation may improve diagnostic precision in differentiating LGGs from HGGs, with potential improvement of patient management and treatment.

scholarly journals Role of diffusional kurtosis imaging in grading of brain gliomas: A diagnostic test accuracy systematic review and meta-analysis

2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv12-iv12
Author(s):  
Gehad Abdalla ◽  
Eser Sanverdi ◽  
Pedro M Machado ◽  
Joey S W Kwong ◽  
Jasmina Panovska-Griffiths ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Test Accuracy ◽  
Low Grade ◽  
Moderate Degree ◽  
Diffusional Kurtosis Imaging ◽  
Low Grade Gliomas ◽  
Effect Model

Abstract Aim and objectives We aim to illustrate the diagnostic performance of diffusional kurtosis imaging (DKI) in the diagnosis of gliomas. Methods and materials A review protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P), registered in the international prospective register of systematic reviews, PROSPERO and published. 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.Data extraction was done in a pre-designed pro forma.Reported sensitivities and specificities were used to construct 2x2 tables and paired forest plots using the Review Manager (RevMan®) software.Random-effect model was pursued using the hierarchical summary receiver operator characteristics. Results Initially, 216 hits were retrieved. Considering duplicates and inclusion criteria; 23 articles were eligible for full-text reading. Ultimately, 19 studies were deemed to be eligible for final inclusion. 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 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) and a moderate degree of heterogeneity (I²= 73.8%). Conclusion DKI shows good diagnostic accuracy in high/low grade gliomas’ differentiation; which might qualify it to be part of the routine clinical practice, however; further evidence is deemed for technique standardization.

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