Comparison of percentage changes in quantitative diffusion parameters for assessing pathological complete response to ne
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SPECIAL SECTION: RECTAL CANCER
Comparison of percentage changes in quantitative diffusion parameters for assessing pathological complete response to neoadjuvant therapy in locally advanced rectal cancer: a meta‑analysis Kai Chen1,2 · Hua‑Long She1,2 · Tao Wu2 · Fang Hu3 · Tao Li3 · Liang‑Ping Luo1 Received: 28 May 2020 / Revised: 2 September 2020 / Accepted: 10 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate and compare the diagnostic performance of percentage changes in apparent diffusion coefficient (∆ADC%) and slow diffusion coefficient (∆D%) for assessing pathological complete response (pCR) to neoadjuvant therapy in patients with locally advanced rectal cancer (LARC). Methods A systematic search in PubMed, EMBASE, the Web of Science, and the Cochrane Library was performed to retrieve related original studies. For each parameter (∆ADC% and ∆D%), we pooled the sensitivity, specificity and calculated the area under summary receiver operating characteristic curve (AUROC) values. Meta-regression and subgroup analyses were performed to explore heterogeneity among the studies on ∆ADC%. Results 15 original studies (804 patients with 805 lesions, 15 studies on ∆ADC%, 4 of the studies both on ∆ADC% and ∆D%) were included. pCR was observed in 213 lesions (26.46%). For the assessment of pCR, the pooled sensitivity, specificity and AUROC of ∆ADC% were 0.83 (95% confidence intervals [CI] 0.76, 0.89), 0.74 (95% CI 0.66, 0.81), 0.87 (95% CI 0.83, 0.89), and ∆D% were 0.70 (95% CI 0.52, 0.84), 0.81 (95% CI 0.65, 0.90), 0.81 (95% CI 0.77, 0.84), respectively. In the four studies on the both metrics, ∆ADC% yielded an equivalent diagnostic performance (AUROC 0.80 [95% CI 0.76, 0.83]) to ∆D%, but lower than in the studies (n = 11) only on ∆ADC% (AUROC 0.88 [95% CI 0.85, 0.91]). Meta-regression and subgroup analyses showed no significant factors affecting heterogeneity. Conclusions Our meta-analysis confirms that ∆ADC% could reliably evaluate pCR in patients with LARC after neoadjuvant therapy. ∆D% may not be superior to ∆ADC%, which deserves further investigation. Keywords Diffusion weighted MRI · Rectal cancer · Neoadjuvant therapy
Kai Chen and Hua-Long She contributed equally to this work. Electronic supplementary material The online version of this article (doi:https://doi.org/10.1007/s00261-020-02770-6) contains supplementary material, which is available to authorized users. * Tao Li [email protected] * Liang‑Ping Luo [email protected] 1
Medical Imaging Center, The First Affiliated Hospital of Jinan University, 613 Huangpu Street, Guangzhou 510630, China
Abbreviations ADC Apparent diffusion coefficient AUROC Area under receiver operating characteristic curve CI Confidence intervals D Slow diffusion coefficient DWI Diffusion-weighted imaging FP False positive 2
Department of Radiology, Affiliated Hospital of Xiangnan University (Clinical College), 25 Renmin West Road, Chenzhou 423000, China
3
College of Medical Imaging and Medical
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