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The T2-FLAIR mismatch sign as a predictor of IDH-mutant, 1p/19q-noncodeleted lower-grade gliomas: a systematic review and diagnostic meta-analysis

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Abstract
Objectives To evaluate the diagnostic performance of the T2-FLAIR mismatch sign for prediction of isocitrate dehydrogenase (IDH)-mutant, 1p/19q-noncodeleted lower-grade gliomas (LGGs) and review studies with false positive results.

Methods The MEDLINE and EMBASE databases were searched up to March 13, 2020, to identify articles reporting the diagnostic performance of the T2-FLAIR mismatch sign for prediction of IDH-mutant, 1p/19q-noncodeleted LGGs (IDHmut-Noncodel) using the search terms (T2 FLAIR mismatch). Pooled sensitivity, specificity, and correlation coefficient for interobserver agreement were calculated.

Results Twelve studies including a total of 1053 patients were included. The median age was 43 (median; range, 14-56). The pooled sensitivity and specificity were 42% (95% CI, 28-58%) and 100% (95% CI, 88-100%), respectively. According to the HSROC curve, the area under the curve was 0.77 (95% CI, 0.73-0.80). Considerable heterogeneity was possible among the studies in terms of both sensitivity and specificity. A threshold effect was suggested and was considered to explain most of the heterogeneity. Four studies reported false positive results for the T2-FLAIR mismatch sign, including dysembryoplastic neuroepithelial tumor, pediatric-type gliomas, and non-neoplastic lesions. The 2 original articles with false positive results showed the highest sensitivities among the 10 studies included in the quantitative analysis, supporting the probability of the threshold effect. The pooled correlation coefficient was 0.87 (95% CI, 0.73-0.94).

Conclusions The T2-FLAIR mismatch sign had a high specificity and interobserver agreement for the prediction of IDHmut-Noncodel. However, the sign demonstrated low sensitivity, and a few studies with false positive cases were also reported.
Author(s)
박상익서종현Philippe ArmandRaymond Y Huang김호성
Issued Date
2021
Type
Article
Keyword
Brain tumorsDiagnosisDiagnostic imagingDiagnostic RadiologyGliomasImagingInternal MedicineInterventional RadiologyMedical researchMedicineMedicine & Public HealthMedicineExperimentalNeuroNeuroradiologyRadiologyUltrasound
DOI
10.1007/s00330-020-07467-4
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7382
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2476128169&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,The%20T2-FLAIR%20mismatch%20sign%20as%20a%20predictor%20of%20IDH-mutant,%201p%2F19q-noncodeleted%20lower-grade%20gliomas:%20a%20systematic%20review%20and%20diagnostic%20meta-analysis&offset=0&pcAvailability=true
Publisher
EUROPEAN RADIOLOGY
Location
미국
Language
영어
ISSN
0938-7994
Citation Volume
31
Citation Number
7
Citation Start Page
5289
Citation End Page
5299
Appears in Collections:
Medicine > Medicine
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