TY - JOUR
T1 - Diagnostic performance of in-phase and opposed-phase chemical-shift imaging for differentiating benign and malignant vertebral marrow lesions
T2 - A meta-analysis
AU - Suh, Chong Hyun
AU - Yun, Seong Jong
AU - Jin, Wook
AU - Park, So Young
AU - Ryu, Chang Woo
AU - Lee, Sun Hwa
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2018/10
Y1 - 2018/10
N2 - OBJECTIVE. The purpose of this study was to assess the diagnostic performance of in-phase and opposed-phase chemical-shift imaging (CSI) for differentiating benign and malignant vertebral bone marrow lesions (BMLs). MATERIALS AND METHODS. The PubMed and EMBASE databases were searched for diagnostic accuracy studies comparing conventional gradient-echo CSI or the Dixon method for differentiating benign and malignant vertebral BMLs with histopathologic or best-value comparator results. Methodologic quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Bivariate modeling and hierarchical summary ROC (HSROC) modeling were performed to evaluate the diagnostic performance of CSI. For heterogeneity exploration, we performed meta-regression analyses. RESULTS. Twelve studies including 663 lesions of 591 patients were included. CSI showed a pooled sensitivity of 0.92 (95% CI, 0.84–0.96), pooled specificity of 0.89 (95% CI, 0.81–0.93), and HSROC AUC of 0.95 (95% CI, 0.93–0.97) for differentiating benign from malignant vertebral BMLs. The corresponding values for differentiating benign from malignant compression fractures were 0.96 (95% CI, 0.81–0.99), 0.89 (95% CI, 0.83–0.93), and 0.93 (95% CI, 0.91–0.95). In meta-regression analysis, minimum TR (< 100 ms), flip angle (< 50°), and Dixon method tended to have higher specificity. Study population, slice thickness (< 5 mm), minimum TE (< 2.3 ms), flip angle (< 50°), and blinding also significantly affected heterogeneity (p < 0.05). CONCLUSION. In-phase and opposed-phase CSI has excellent diagnostic performance for differentiating benign and malignant vertebral BMLs. CSI with a short TR, small flip angle, and Dixon method is recommended for more accurate diagnosis as specificity increases.
AB - OBJECTIVE. The purpose of this study was to assess the diagnostic performance of in-phase and opposed-phase chemical-shift imaging (CSI) for differentiating benign and malignant vertebral bone marrow lesions (BMLs). MATERIALS AND METHODS. The PubMed and EMBASE databases were searched for diagnostic accuracy studies comparing conventional gradient-echo CSI or the Dixon method for differentiating benign and malignant vertebral BMLs with histopathologic or best-value comparator results. Methodologic quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Bivariate modeling and hierarchical summary ROC (HSROC) modeling were performed to evaluate the diagnostic performance of CSI. For heterogeneity exploration, we performed meta-regression analyses. RESULTS. Twelve studies including 663 lesions of 591 patients were included. CSI showed a pooled sensitivity of 0.92 (95% CI, 0.84–0.96), pooled specificity of 0.89 (95% CI, 0.81–0.93), and HSROC AUC of 0.95 (95% CI, 0.93–0.97) for differentiating benign from malignant vertebral BMLs. The corresponding values for differentiating benign from malignant compression fractures were 0.96 (95% CI, 0.81–0.99), 0.89 (95% CI, 0.83–0.93), and 0.93 (95% CI, 0.91–0.95). In meta-regression analysis, minimum TR (< 100 ms), flip angle (< 50°), and Dixon method tended to have higher specificity. Study population, slice thickness (< 5 mm), minimum TE (< 2.3 ms), flip angle (< 50°), and blinding also significantly affected heterogeneity (p < 0.05). CONCLUSION. In-phase and opposed-phase CSI has excellent diagnostic performance for differentiating benign and malignant vertebral BMLs. CSI with a short TR, small flip angle, and Dixon method is recommended for more accurate diagnosis as specificity increases.
KW - Bone marrow neoplasm
KW - Chemical-shift imaging
KW - Compression fracture
KW - Meta-analysis
KW - Spine
UR - http://www.scopus.com/inward/record.url?scp=85054152479&partnerID=8YFLogxK
U2 - 10.2214/AJR.17.19306
DO - 10.2214/AJR.17.19306
M3 - Article
C2 - 30160981
AN - SCOPUS:85054152479
SN - 0361-803X
VL - 211
SP - W188-W197
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 4
ER -