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Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis

High-grade gliomas remain the most common primary brain tumour with limited treatments options and early recurrence rates following adjuvant treatments. However, differentiating true tumour progression (TTP) from treatment-related effects or pseudoprogression (PsP), may critically influence subseque...

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Autores principales: Taylor, Chris, Ekert, Justyna O., Sefcikova, Viktoria, Fersht, Naomi, Samandouras, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9345984/
https://www.ncbi.nlm.nih.gov/pubmed/35918373
http://dx.doi.org/10.1038/s41598-022-16726-x
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author Taylor, Chris
Ekert, Justyna O.
Sefcikova, Viktoria
Fersht, Naomi
Samandouras, George
author_facet Taylor, Chris
Ekert, Justyna O.
Sefcikova, Viktoria
Fersht, Naomi
Samandouras, George
author_sort Taylor, Chris
collection PubMed
description High-grade gliomas remain the most common primary brain tumour with limited treatments options and early recurrence rates following adjuvant treatments. However, differentiating true tumour progression (TTP) from treatment-related effects or pseudoprogression (PsP), may critically influence subsequent management options. Structural MRI is routinely employed to evaluate treatment responses, but misdiagnosis of TTP or PsP may lead to continuation of ineffective or premature cessation of effective treatments, respectively. A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses method. Embase, MEDLINE, Web of Science and Google Scholar were searched for methods applied to differentiate PsP and TTP, and studies were selected using pre-specified eligibility criteria. The sensitivity and specificity of included studies were summarised. Three of the identified methods were compared in a separate subgroup meta-analysis. Thirty studies assessing seven distinct neuroimaging methods in 1372 patients were included in the systematic review. The highest performing methods in the subgroup analysis were DWI (AUC = 0.93 [0.91–0.95]) and DSC-MRI (AUC = 0.93 [0.90–0.95]), compared to DCE-MRI (AUC = 0.90 [0.87–0.93]). 18F-fluoroethyltyrosine PET (18F-FET PET) and amide proton transfer-weighted MRI (APTw-MRI) also showed high diagnostic accuracy, but results were based on few low-powered studies. Both DWI and DSC-MRI performed with high sensitivity and specificity for differentiating PsP from TTP. Considering the technical parameters and feasibility of each identified method, the authors suggested that, at present, DSC-MRI technique holds the most clinical potential.
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spelling pubmed-93459842022-08-04 Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis Taylor, Chris Ekert, Justyna O. Sefcikova, Viktoria Fersht, Naomi Samandouras, George Sci Rep Article High-grade gliomas remain the most common primary brain tumour with limited treatments options and early recurrence rates following adjuvant treatments. However, differentiating true tumour progression (TTP) from treatment-related effects or pseudoprogression (PsP), may critically influence subsequent management options. Structural MRI is routinely employed to evaluate treatment responses, but misdiagnosis of TTP or PsP may lead to continuation of ineffective or premature cessation of effective treatments, respectively. A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses method. Embase, MEDLINE, Web of Science and Google Scholar were searched for methods applied to differentiate PsP and TTP, and studies were selected using pre-specified eligibility criteria. The sensitivity and specificity of included studies were summarised. Three of the identified methods were compared in a separate subgroup meta-analysis. Thirty studies assessing seven distinct neuroimaging methods in 1372 patients were included in the systematic review. The highest performing methods in the subgroup analysis were DWI (AUC = 0.93 [0.91–0.95]) and DSC-MRI (AUC = 0.93 [0.90–0.95]), compared to DCE-MRI (AUC = 0.90 [0.87–0.93]). 18F-fluoroethyltyrosine PET (18F-FET PET) and amide proton transfer-weighted MRI (APTw-MRI) also showed high diagnostic accuracy, but results were based on few low-powered studies. Both DWI and DSC-MRI performed with high sensitivity and specificity for differentiating PsP from TTP. Considering the technical parameters and feasibility of each identified method, the authors suggested that, at present, DSC-MRI technique holds the most clinical potential. Nature Publishing Group UK 2022-08-02 /pmc/articles/PMC9345984/ /pubmed/35918373 http://dx.doi.org/10.1038/s41598-022-16726-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Taylor, Chris
Ekert, Justyna O.
Sefcikova, Viktoria
Fersht, Naomi
Samandouras, George
Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis
title Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis
title_full Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis
title_fullStr Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis
title_full_unstemmed Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis
title_short Discriminators of pseudoprogression and true progression in high-grade gliomas: A systematic review and meta-analysis
title_sort discriminators of pseudoprogression and true progression in high-grade gliomas: a systematic review and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9345984/
https://www.ncbi.nlm.nih.gov/pubmed/35918373
http://dx.doi.org/10.1038/s41598-022-16726-x
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