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• Clinical Article •
Comparison of intraoperative magnetic resonance imaging, ultrasound and fluorescence guided with 5-ALA in the diagnosis of residual glioma: a Meta-analysis
YE Dongman  YANG Shaojie  YU Tao 

Cite this article as: Ye DM, Yang SJ, Yu T. Comparison of intraoperative magnetic resonance imaging, ultrasound and fluorescence guided with 5-ALA in the diagnosis of residual glioma: a Meta-analysis. Chin J Magn Reson Imaging, 2019, 10(5): 342-347. DOI:10.12015/issn.1674-8034.2019.05.005.


[Abstract] Objective: To evaluate the value of intraoperative magnetic resonance imaging, intraoperative ultrasound and intraoperative fluorescence guided with 5-aminolevulinic acid (5-ALA) in the diagnosis of residual glioma.Materials and Methods: Literatures on intraoperative MRI, intraoperative ultrasound and 5-ALA in the diagnosis of residual glioma were collected from Pubmed, Embase, the Cochrane Library, CNKI and Wanfang Database from the establishment of the database to April 2018. Two researchers independently screened the literature according to inclusion and exclusion criterias, and used QUADAS-2 to evaluate the quality of the included literatures. The sensitivity (Sen), specificity (Spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR) were analyzed by Meta- Disc 1.4 and Stata 13.0 software. The heterogeneity was tested and the summary receiver operating characteristic curve (SROC) was calculated.Results: Thirty-four papers were included and analyzed by random effect model. The Sen, Spe, PLR, NLR and DOR of iMRI, iUS and 5-ALA were 0.698 (0.651, 0.742), 0.819 (0.762, 0.867), 3.815 (2.208, 7.175), 0.230 (0.110, 0.484), 22.556 (5.657, 89.933). 0.746 (0.717, 0.773), 0.872 (0.850, 0.892), 4.041 (2.588, 6.310), 0.313 (0.227, 0.433), 15.951 (8.190, 31.068). 0.752 (0.726, 0.777), 0.862 (0.839, 0.882), 3.877 (2.593, 5.798), 0.313 (0.230, 0.425), 15.256 (8.309, 28.046). The AUC of iMRI, iUS, 5-ALA were 0.897, 0.865, 0.891. There were no significant statistical significance by Z test.Conclusions: iMRI, iUS, 5-ALA have important diagnostic value for the diagnosis of residual tumor after glioma resection. iMRI and iUS can provide important imaging information of tumor resection, peripheral edema, hematoma, etc. The AUC of iMRI is slightly higher than that of iUS, 5-ALA.iMRI could provide real-time information of the overall brain hemorrhage and edema in the operation. The specificity of iUS is slightly higher than the other two technologies, and it can reduce the rate of misdiagnosis. It can make great dianostic significance in the functional area of glioma surgery. The sensitivity of 5-ALA is higher, which can reduce the rate of missed diagnosis. However, there is a certain deficiency in brain function imaging. So it cannot completely replace iMRI and iUS. At present, the combination of multiple imaging techniques in the operation plays a great role in glioma resection, which can greatly improve the accuracy of neurosurgery.
[Keywords] magnetic resonance imaging；ultrasonography；fluorescence technology；monitoring, intraoperative；glioma；literature based discovery

YE Dongman Department of Diagnostic Ultrasound, Cancer Hospital of China Medical University, Liaoning Cancer Hosptial& Institute, Shenyang 110042, China

YANG Shaojie Department of Gynecology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China

YU Tao* Department of Diagnostic Ultrasound, Cancer Hospital of China Medical University, Liaoning Cancer Hosptial& Institute, Shenyang 110042, China

*Correspondence to: Yu T, E-mail: yutao@cancerhosp-ln-cmu.com

Conflicts of interest   None.

Received  2018-09-27
Accepted  2019-01-20
DOI: 10.12015/issn.1674-8034.2019.05.005
Cite this article as: Ye DM, Yang SJ, Yu T. Comparison of intraoperative magnetic resonance imaging, ultrasound and fluorescence guided with 5-ALA in the diagnosis of residual glioma: a Meta-analysis. Chin J Magn Reson Imaging, 2019, 10(5): 342-347. DOI:10.12015/issn.1674-8034.2019.05.005.

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