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Systematic ReviewSystematic Review
Open Access

Positron emission tomography and perfusion weighted imaging in the detection of brain tumors recurrence

A meta-analysis

Tareef S. Daqqaq and Ayman S. Alhasan
Neurosciences Journal July 2022, 27 (3) 131-142; DOI: https://doi.org/10.17712/nsj.2022.3.20210146
Tareef S. Daqqaq
From the Department of Radiology, College of Medicine, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia.
MBBS, Facharzt
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  • For correspondence: [email protected]
Ayman S. Alhasan
From the Department of Radiology, College of Medicine, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia.
MBBS, DES
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    Figure 1

    - An outline of the PRISMA guidelines used to conduct this meta-analysis.

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    Figure 2

    - Risk of bias items presented as percentages across all articles. PET: positron emission tomography, PWI: perfusion-weighted imaging, CI: confidence interval

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    Figure 3

    - Forest plot of the rate ratio of accuracy between perfusion-weighted imaging (PWI) and positron emission tomography (PET). CI: confidence interval

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    Figure 4

    - Forest plot of the rate ratio of sensitivity between perfusion-weighted imaging (PWI) and positron emission tomography (PET). CI: confidence interval

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    Figure 5

    - Forest plot of the rate ratio of sensitivity between perfusion-weighted imaging (PWI) and positron emission tomography (PET). CI: confidence interval

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    Figure 6

    - Forest plot showing the rate ratio of (A) accuracy and (B) sensitivity between PWI and positron emission tomography (PET).

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    Figure 7

    - Funnel plot showing no publication bias in terms of (A) accuracy, (B) sensitivity, and (C) specificity among the studies.

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    Table 1

    - Features of included articles (N=14).

    Author name and yearStudy designCountryPeriod since completion of radiation (month)Type of tumorNumber of patients
    Cicone et al28 2015RetrospectiveItaly3 to 45Brain metastases42
    Dandois et al29 2010RetrospectiveBelgium2Astrocytic tumours with grades III Astrocytic tumours with grades IV grade III oligoastrocytomas28
    D’Souza et al30 2014ProspectiveIndia7 to 19High-grade gliomas (III-IV)29
    Estrada et al31 2008ProspectiveMexicoNDChoroid plexus carcinoma Anaplastic astrocytoma Glioblastoma multiforme Gliosarcoma Anaplastic oligoastrocytoma30
    Hatzoglou et al32 2016ProspectiveUSA≤3Gliomas (II to IV) Brain metastases53
    Hojjati et al33 2018RetrospectiveUSA2 to 90Glioblastoma multiforme24
    Jabeen et al34 2021RetrospectiveIndia3 to 12Glioblastoma multiforme oligodendroglioma (grade II-IV) Anaplastic oligodendro glioma Anaplastic astrocytoma48
    Kim et al35 2010RetrospectiveKorea3 to 91Anaplastic astrocytoma Glioblastoma Anaplastic oligodendroglioma10
    Prat et al36 2010RetrospectiveSpainNDAnaplastic astrocytoma Astrocytoma Ependymoma Glioblastoma multiform24
    Pyka et al37 2018RetrospectiveGermany15Glioblastoma Anaplastic Astrocytoma, Diffuse astrocytoma Oligodendroglioma Anaplastic oligodendroglioma47
    Qiao et al38 2019RetrospectiveChina>3High-grade tumor (grade III-IV)42
    Sacconi et al39 2016RetrospectiveUSANDLow- and high-grade tumor (grade II to IV)20
    Seligman et al40 2019RetrospectiveCanada2 to 156Grade III Grade IV41
    Steidl et al41 2021RetrospectiveGermany6 to 12Oligodendroglioma Astrocytoma Astrocytoma Glioblastoma104

    ND: not defined, USA: United States of America

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      Table 1

      - Features of included articles (N=14) (continuation).

      Author name and yearAgeNumber of lesionsModality and optimal cutoffThe amino acid tracers of PETPET modalityFollow-up period (month)Reference standard
      Cicone et al28 201538–8446 (PET) 37 (PWI)*SUVLmax/Bkgrmax (rSUV), 1.59 *rCBV, 2.14F-DOPAPET/CT6Histopathology+clinico-radiological follow-up
      Dandois et al29 201025-7433*rCBV, 182% *rCBV, 378%11C-methioninePET3 to 40Histopathology
      D’Souza et al30 201415-6129*SUV, ND *rCBV, 182%11C-methioninePET/CT6 to 28Histopathology+clinico-radiological follow-up
      Estrada et al31 200817-7730*SUV, ND *rCBV, 1.218F-FDGPET/MRI6 to 21Clinical and radiological criteria
      Hatzoglou et al32201619–8155*SUVratio, 1.2 *Vpratio, 2.118F-FDGPET/CT6Histopathology+clinico-radiological follow-up
      Hojjati et al33 201834-8128 (PET/MRI) 27 (PWI) 23 (PET/CT)*r-Mean, 1.47 *CBVmax, 3.3218F-FDGPET/CT8 to 18Histopathology+clinico-radiological follow-up
      Jabeen et al34 20218-7148*TBRmax, 1.23 *rCBVratio, 1.3811C-methioninePET/MRI1 to 14Histopathology+clinico-radiological follow-up
      Kim et al35 201031-6610*Lmax/Rmax, 2.64 *rCBV, 3.6911C-methionine + 18F-FDGPET6 to 50Histopathology+clinical course
      Prat et al36 201018-7026ND18F-FDGPET5Histopathology+clinico-radiological follow-up
      Pyka et al37 201842-6463*TBR, 2.07 *rCBV, 3.3518F-FETPET/MRI6Histopathology+ imaging follow-up
      Qiao et al38 2019ND42*TBRSUVmax, 1.85 *rCBVmean, 1.8311C-methioninePET/CT6Histopathology+ Clinical follow up
      Sacconi et al39 201614–7434*SUVmean, <4.0 *rCBVmean, <1.7418F-FDGPET/MRI3 to 6Histopathology
      Seligman et al40 201921-7941*Whole-tumor SUVmean divided by SUVmean of normal white matter >0.75 *Mean Ktrans of whole tumor divided by mean Ktrans of contralateral brain >4.518F-FDGPET/MRI6Histopathology+clinico-radiological follow-up
      Steidl et al41 202120–78104*Slope, <0.69 *rCBVmax, >2.8518F-FETPET/MRI6Histopathology+clinico-radiological follow-up

      ND - not defined, PET - positron emission tomography, MRI - magnetic resonance imaging, CT - computed tomography, PWI - perfusion-weighted imaging, 18F-FDG - 18fluorine-fluorodeoxyglucose, 18F-FET - 18F-fluoro-ethyl-tyrosine, 18F-FLT- (18)Fluorothymidine, CBV - Cerebral Blood Volume, TBR - Tumor to Background Ratio SUV - Standardized Uptake Value, F-DOPA - fluorodopa

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      Neurosciences Journal: 27 (3)
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      1 Jul 2022
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      Positron emission tomography and perfusion weighted imaging in the detection of brain tumors recurrence
      Tareef S. Daqqaq, Ayman S. Alhasan
      Neurosciences Journal Jul 2022, 27 (3) 131-142; DOI: 10.17712/nsj.2022.3.20210146

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      Positron emission tomography and perfusion weighted imaging in the detection of brain tumors recurrence
      Tareef S. Daqqaq, Ayman S. Alhasan
      Neurosciences Journal Jul 2022, 27 (3) 131-142; DOI: 10.17712/nsj.2022.3.20210146
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