ObjectiveThe purpose of this study was to evaluate the diagnostic accuracy of 6 different imaging modalities for differentiating glioma recurrence from postradiotherapy changes by performing a network meta-analysis (NMA) using direct comparison studies with 2 or more imaging techniques.Data sourcesPubMed, Scopus, EMBASE, the Web of Science and the Cochrane Library were searched from inception to August 2021. The Confidence In Network Meta-Analysis (CINeMA) tool was used to evaluate the quality of the included studies with the criterion for study inclusion being direct comparison using 2 or more imaging modalities.Data extraction and synthesisThe consistency was evaluated by examining the agreement between direct and indirect effects. NMA was performed and the surface under the the cumulative ranking curve (SUCRA) values was obtained to calculate the probability of each imaging modality being the most effective diagnostic method. The CINeMA tool was used to evaluate the quality of the included studies.Main outcomes and measuresDirect comparison, inconsistency test, NMA and SUCRA values.ResultsA total of 8853 potentially relevant articles were retrieved and 15 articles met the inclusion criteria.18F-FET showed the highest SUCRA values for sensitivity, specificity, positive predictive value and accuracy, followed by18F-FDOPA. The quality of the included evidence is classified as moderate.Conclusion and relevanceThis review indicates that18F-FET and18F-FDOPA may have greater diagnostic value for glioma recurrence relative to other imaging modalities (Grading of Recommendations, Assessment, Development and Evaluations B).PROSPERO registration numberCRD42021293075.
Background:
Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) has become a widely used liver-specific contrast agent worldwide, but its value and limitations as a diagnostic technique with hepatocellular carcinoma (HCC), have not been assessed.
Introduction:
A review of the latest evidence available on the diagnostic value of Gd-EOB-DTPA-enhanced MRI for the evaluation of HCC is reported.
Methods:
A systematic, comprehensive literature search was conducted with PubMed, Scopus, EMBASE, the Web of Science, the Cochrane Library, CNKI, vip, wanfangdata and CBM from inception to June 31, 2020. The QUADAS-2 tool was used to evaluate the quality of the included studies. Pooled sensitivity (SEN), pooled specificity (SPE), pooled positive likelihood ratio (PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio (dOR) and summary receiver operating characteristic (SROC) curves were calculated to assess the diagnostic value of the individual diagnostic tests.
Results:
A total of 47 articles were included, involving a total of 6362 nodules in 37 studies based on per-lesion studies. There were 13 per-patient studies, including a total of 1816 patients. The results of the meta-analysis showed that the per-lesion studies pooled weighted values were SEN 0.90 [95% confidence interval (CI): 0.87-0.92], SPE 0.92 (95%CI: 0.90-0.94), PLR 11.6 (95%CI: 8.8-15.2), NLR 0.11 (95%CI: 0.09-0.14) and dOR 107.0 (95%CI: 74.0-155.0). The AUC of the SROC curve was 0.96. The per-patient studies pooled weighted values were SEN 0.84 [95% confidence interval (CI): 0.78-0.89], SPE 0.92 (95%CI: 0.88-0.94), PLR 10.4 (95%CI: 7.4-14.6), NLR 0.17 (95%CI: 0.12-0.24) and dOR 61.0 (95%CI: 42.0-87.0). The AUC of the SROC curve was 0.95 and subgroup analyses were performed.
Conclusions:
The diagnostic value of Gd-EOB-DTPA for HCC was quantitatively evaluated in a per-lesion study and a per-patient study using a systematic review of the literature. A positive conclusion was drawn: Gd-EOB-DTPA-enhanced imaging is a valuable diagnostic technique for HCC. The size of the nodules and the selection of the imaging diagnostic criteria may affect the diagnostic sensitivity.
Studies have shown that miR-21 is abnormally expressed in breast cancer patients, implying that miR-21 could be used as a potential marker for clinical applications. In this study, we explore the diagnostic value of miR-21 in breast cancer, with the aim of providing evidence-based clinical evidence.All relevant English literature from PubMed, EMBASE, Web of Science, Cochrane Library and Scopus databases were searched since inception to 23 January 2022, and 9 articles were screed for inclusion. QUADAS-2 for literature quality assessment, GRADE for evidence grading. Statistical analyses were performed using the R 4.0.1 and Revman 5.3. The results were validated using Stata 15.1 software. Subgroup analysis was also performed according to the source of miR-21 and miR-21 combinations. All of the included studies are of moderate-high quality. This meta-analysis calculated a combined sensitivity of 0.91 [95% CI (0.86, 0.95)], a combined specificity of 0.85 [95% CI (0.77, 0.91)],DOR of 56.62 [ 95% CI (21.00, 184.83)], NLR of 0.11 [95% CI ( 0.05, 0.18)] and PLR of 6.35 [95% CI( 3.66, 11.16)]; miR-21 GRADE classification A is recommended.The current evidence suggests that miR-21 shows satisfactory diagnostic value as a biomarker for breast cancer; miR-21 in combination with multiple miRNAs will further improve diagnostic accuracy.
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