Background: Accurate diagnosis of high-grade glioma and solitary brain metastasis is clinically important because it affects the patient's outcome and alters patient management.
Purpose: To evaluate the diagnostic performance of DWI and DTI for differentiating high-grade glioma from solitary brain metastasis.
Data sources: A literature search of Ovid MEDLINE and EMBASE was conducted up to November 10, 2017.
Study selection: Studies evaluating the diagnostic performance of DWI and DTI for differentiating high-grade glioma from solitary brain metastasis were selected.
Data analysis: Summary sensitivity and specificity were established by hierarchic logistic regression modeling. Multiple subgroup analyses were also performed.
Data synthesis: Fourteen studies with 1143 patients were included. The individual sensitivities and specificities of the 14 included studies showed a wide variation, ranging from 46.2% to 96.0% for sensitivity and 40.0% to 100.0% for specificity. The pooled sensitivity of both DWI and DTI was 79.8% (95% CI, 70.9%-86.4%), and the pooled specificity was 80.9% (95% CI, 75.1%-85.5%). The area under the hierarchical summary receiver operating characteristic curve was 0.87 (95% CI, 0.84-0.89). The multiple subgroup analyses also demonstrated similar diagnostic performances (sensitivities of 76.8%-84.7% and specificities of 79.7%-84.0%). There was some level of heterogeneity across the included studies (I2 = 36%); however, it did not reach a level of concern.
Limitations: The included studies used various DWI and DTI parameters.
Conclusions: DWI and DTI demonstrated a moderate diagnostic performance for differentiation of high-grade glioma from solitary brain metastasis.
© 2018 by American Journal of Neuroradiology.