Meta-Analysis
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Feb 22, 2019; 7(2): 51-65
Published online Feb 22, 2019. doi: 10.13105/wjma.v7.i2.51
Evaluation of tumor response to antiangiogenic therapy in patients with recurrent gliomas using contrast-enhanced perfusion-weighted magnetic resonance imaging techniques: A meta-analysis
Akanganyira Kasenene, Aju Baidya, Salman Shams, Hai-Bo Xu
Akanganyira Kasenene, Aju Baidya, Salman Shams, Hai-Bo Xu, Department of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, Hubei Province, China
Author contributions: Kasenene A and Baidya A contributed equally to this work; Kasenene A and Xu HB designed this study; Kasenene A and Baidya A analyzed the data; Kasenene A, Baidya A, Shams S, and Xu HB drafted the paper.
Conflict-of-interest statement: There is no conflict of interest.
PRISMA 2009 Checklist statement: The current manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hai-Bo Xu, MD, PhD, Director, Doctor, Professor, Teacher, Department of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan 430071, Hubei Province, China. xuhaibo1120@hotmail.com
Telephone: +86-27-67812533 Fax: +86-27-67812533
Received: January 16, 2019
Peer-review started: January 16, 2019
First decision: January 30, 2019
Revised: February 7, 2019
Accepted: February 13, 2019
Article in press: February 14, 2019
Published online: February 22, 2019
ARTICLE HIGHLIGHTS
Research background

The perfusion-weighted imaging is an advanced magnetic resonance (MR) technique capable of giving a detailed hemodynamic status of the tumors; this has prompted a surge of studies both in vitro and in vivo with some of these studies done on humans. The current meta-analysis is exploring the clinical application of this method in recurrent glioma patients after antiangiogenic therapy.

Research motivation

So far, biopsy, which is too invasive, is the gold standard for diagnosing brain tumors; perfusion-weighted magnetic resonance imaging (PW-MRI) offers a non-invasive way for diagnosing, grading, and assessing progression of brain tumors. Therefore, scientifically proving that this method works is of paramount importance in the spirit of encouraging its incorporation to the daily clinical practices.

Research objectives

The primary objective of this study was to assess the use of PW-MRI in evaluating the response of recurrent gliomas to antiangiogenic treatment based on the already available literature, and the finding of this study showed that both dynamic contrast-enhanced MRI and dynamic susceptibility contrast MRI could be used for this purpose. These findings would warrant further human-based studies on this MR technique to achieve its universal acceptability for clinical use.

Research methods

Studies related to this topic were searched in PubMed, Google Scholar, and other scientific search engines. The selected studies were sorted according to the Preferred Reporting Items for Systematic Reviews guidelines, and only six studies meeting the inclusion criteria were included in the current meta-analysis. Meta-Disc 1.4 software and Microsoft Excel were used to analyze the data.

Research results

The sensitivity and specificity of this study proved that PW-MR techniques are capable of evaluating treatment response in patients with brain tumors, i.e., recurrent gliomas, and these findings, together with other related studies, mean that we are getting a step closer to its complete adaption for clinical use. The only concern is what should be done to improve and perfect this technique.

Research conclusions

This meta-analysis showed that PW-MRI could be used to assess brain tumor therapeutic response. However, more studies must be conducted because that is the only way we will be sure of its clinical efficacy in diagnosing, follow-up, and treatment of brain tumors.

Research perspectives

While searching for studies, we realized that very few studies had been carried out on human subjects; this tells us that there is more to be done until it is adopted universally for clinical use. There are many studies carried on animals, which mean the technique is being perfected and improved with each passing day. We need more studies assessing its application on human subjects.