Imaging prediction of isocitrate dehydrogenase (IDH) mutation in patients with glioma: a systemic review and meta-analysis
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To evaluate the imaging features of isocitrate dehydrogenase (IDH) mutant glioma and to assess the diagnostic performance of magnetic resonance imaging (MRI) for prediction of IDH mutation in patients with glioma.
A systematic search of Ovid-MEDLINE and EMBASE up to 10 October 2017 was conducted to find relevant studies. The search terms combined synonyms for ‘glioma’, ‘IDH mutation’ and ‘MRI’. Studies evaluating the imaging features of IDH mutant glioma and the diagnostic performance of MRI for prediction of IDH mutation in patients with glioma were selected. The pooled summary estimates of sensitivity and specificity and their 95% confidence intervals (CIs) were calculated using a bivariate random-effects model. The results of multiple subgroup analyses are reported.
Twenty-eight original articles in a total of 2,146 patients with glioma were included. IDH mutant glioma showed frontal lobe predominance, less contrast enhancement, well-defined border, high apparent diffusion coefficient (ADC) value and low relative cerebral blood volume (rCBV) value. For the meta-analysis that included 18 original articles, the summary sensitivity was 86% (95% CI, 79%–91%) and the summary specificity was 87% (95% CI, 78–92%). In a subgroup analysis, the summary sensitivity of 2-hydroxyglutarate magnetic resonance spectroscopy (MRS) [96% (95% CI, 91–100%)] was higher than the summary sensitivities of other imaging modalities.
IDH mutant glioma consistently demonstrated less aggressive imaging features than IDH wild-type glioma. Despite the variety of different MRI techniques used, MRI showed the potential to non-invasively predict IDH mutation in patients with glioma. 2-Hydroxyglutarate MRS shows higher pooled sensitivity than other imaging modalities.
• IDH mutant glioma showed frontal lobe predominance, less contrast enhancement, well-defined border, high ADC value, and low rCBV value.
• The diagnostic performance of MRI for prediction of IDH mutation in patients with glioma is within a clinically acceptable range, the summary sensitivity was 86% (95% CI, 79–91%) and the summary specificity was 87% (95% CI, 78–92%).
• In a subgroup analysis, the summary sensitivity of 2-hydroxyglutarate MRS [96% (95% CI, 91–100%)] was higher than the summary sensitivities of other imaging modalities.
KeywordsGlioma Magnetic resonance imaging Diffusion Perfusion Magnetic resonance spectroscopy
Apparent diffusion coefficient
Amide proton transfer-weighted
Hierarchical summary receiver operating characteristic
Magnetic resonance imaging
Magnetic resonance spectroscopy
Preferred reporting items for systematic reviews and meta-analyses
Quality assessment of diagnostic accuracy studies-2
Relative cerebral blood volume
World Health Organization
This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (1720030).
Compliance with ethical standards
The scientific guarantor of this publication is Ho Sung Kim.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors (Chong Hyun Suh) has significant statistical expertise (4 years of experience in a systematic review and meta-analysis).
Institutional Review Board approval was not required because of the nature of our study, which was a systemic review and meta-analysis.
Written informed consent was not required for this study because of the nature of our study, which was a systemic review and meta-analysis.
• A systemic review and meta-analysis performed at one institution.
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