Differentiation of lymphomatous, metastatic, and non-malignant lymphadenopathy in the neck with quantitative diffusion-weighted imaging: systematic review and meta-analysis.

Purpose: To perform a systematic review and meta-analysis of literature comparing average apparent diffusion coefficient (ADC) for differentiating lymphomatous, metastatic, and non-malignant cervical lymphadenopathy. Methods: We performed a comprehensive literature search of Ovid MEDLINE, EMBASE, Co...

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Publicado en:Neuroradiology Vol. 61; no. 8; pp. 897 - 911
Autores principales: Payabvash, Seyedmehdi, Brackett, Alexandria, Forghani, Reza, Malhotra, Ajay
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Springer Nature Aug2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Differentiation of lymphomatous, metastatic, and non-malignant lymphadenopathy in the neck with quantitative diffusion-weighted imaging: systematic review and meta-analysis.
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          Payabvash, Seyedmehdi
          Brackett, Alexandria
          Forghani, Reza
          Malhotra, Ajay
        affil: Department of Radiology and Biomedical Imaging, Yale School of Medicine, Box 208042, 333 Cedar St, Tompkins East 2, 06520-8042, New Haven, CT, USA
      sug:
        subj:
          Neck Pathology
          Lymph Nodes Pathology
          Lymphatic Diseases Classification
          Lymphatic Diseases Diagnosis
          Magnetic Resonance Imaging Methods
          Human
          Systematic Review
          Meta Analysis
          Medline
          Embase
          Cochrane Library
          Confidence Intervals
          Odds Ratio
          ROC Curve
          Lymphoma Diagnosis
          Neoplasm Metastasis Diagnosis
          Predictive Value of Tests
      ab: Purpose: To perform a systematic review and meta-analysis of literature comparing average apparent diffusion coefficient (ADC) for differentiating lymphomatous, metastatic, and non-malignant cervical lymphadenopathy. Methods: We performed a comprehensive literature search of Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection. Studies comparing average ADC of lymphomatous, metastatic, and non-malignant neck lymph nodes were included. The standardized mean difference and 95% confidence interval (CI) was calculated using random-effects models. In subgroup analysis of those studies applying ADC threshold for differentiation of cervical lymphadenopathy, pooled diagnostic odds ratio (DOR) and summary receiver operating characteristics (sROC) area under the curve (AUC) were determined. Results: A total of 27 studies with 1165 patients were included, pooling data from 225 lymphomatous, 1162 metastatic, and 1333 non-malignant cervical lymph nodes. The average ADC values were lower in lymphomatous compared to metastatic nodes, and in metastatic compared to non-malignant nodes with a standardized mean difference of − 1.36 (95% CI: − 1.71 to − 1.01, p < 0.0001) and − 1.61 (95% CI: − 2.19 to − 1.04, p < 0.0001), respectively. In subgroup analysis, applying ADC threshold could differentiate lymphomatous from metastatic lymphadenopathy with DOR of 52.07 (95% CI 25.45–106.54) and sROC AUC of 0.936 (95% CI 0.896–0.979) and differentiate metastatic from non-malignant nodes with DOR of 39.45 (95% CI 16.92–92.18) and sROC AUC of 0.929 (95% CI 0.873–0.966). Conclusions: Quantitative assessment of ADC can help with differentiation of suspicious cervical lymph nodes, particularly in those patients without prior history of malignancy or unknown primary cancer site.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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