Comparison of Three Different MR Perfusion Techniques and MR Spectroscopy for Multiparametric Assessment in Distinguishing Recurrent High-Grade Gliomas from Stable Disease

Role of magnetic resonance spectroscopy for the differentiation of recurrent glioma from radiation necrosis: A systematic review and meta-analysis

“…1. Eighteen articles [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] comprising a total sample size of 455 patients (447 lesions) with suspected glioma recurrence after radiotherapy, met all inclusion and exclusion criteria, and were included in our metaanalysis. The characteristics of the included studies are presented in Table 1.…”

MR perfusion-weighted imaging in the evaluation of high-grade gliomas after treatment: a systematic review and meta-analysis

“…Seventeen studies evaluated DSC, [13][14][15]17,18,20,[23][24][25][27][28][29][30][31]34,36,39 8 evaluated DCE, 16,19,21,22,32,37,38,40 and 3 evaluated both DSC and DCE. 26,33,35 There were a total of 937 cases (54%) of tumor progression and 806 cases (46%) of treatment change. Investigators reported that pseudoprogression was the specific treatment effect under evaluation in 13 studies, 14,17,18,[29][30][31]33,34,[36][37][38][39][40] radiation necrosis in 4 studies, 15,16,19,21 and both in 2 studies.…”

“…Five studies relied solely on clinical and/or radiological follow-up for confirmation of PWI findings without any histopathological confirmation. 30,35,36,38,40 Among the other 23 studies with at least one subject with histological follow-up, 14 provided some histological criteria for tumor…”

“…39 Seven different types of PWI processing software were utilized, not including in-house software in several studies. Among DSC studies, 7 utilized contrast preloading, often in combination with postprocessing algorit hms, 20,[23][24][25][26]33,35 while 10 utilized only postprocessing techniques. 13,14,17,18,27,28,30,31,34,36 Six of the DCE studies used a model-free method, 19,22,26,32,33,37 4 used a 2-compartment model, 16,35,38,40 and 1 used both.…”

Role of MRI in Primary Brain Tumor Evaluation

“…51 One study comparing, among other techniques, DSC and DCE, found that DSC showed better diagnostic performance in distinguishing recurrent HGGs from stable disease. 52 There can be considerable variation between MRI centers, and therefore standardization and optimization of protocols are concerns with MR perfusion. Several efforts are underway to address these issues, including involvement by the American College of Radiology Imaging Network, whose protocols are becoming the de facto standard for many clinical trials.…”