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European Radiology Nov 2014To evaluate the effect of the choice of b values and prior use of contrast medium on apparent diffusion coefficients (ADCs) of breast lesions derived from... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the effect of the choice of b values and prior use of contrast medium on apparent diffusion coefficients (ADCs) of breast lesions derived from diffusion-weighted imaging (DWI), and on the discrimination between benign and malignant lesions.
METHODS
A literature search of relevant DWI studies was performed. The accuracy of DWI to characterize lesions by using b value ≤600 s/mm(2) and b value >600 s/mm(2) was presented as pooled sensitivity and specificity, and the ADC was calculated for both groups. Lesions were pooled as pre- or post-contrast DWI.
RESULTS
Of 198 articles, 26 met the inclusion criteria. Median ADCs were significantly higher (13.2-35.1 %, p < 0.001) for the group of b values ≤600 s/mm(2) compared to >600 s/mm(2). The sensitivity in both groups was similar (91 % and 89 %, p = 0.495) as well as the specificity (75 % and 84 %, p = 0.237). Contrast medium had no significant effects on the ADCs (p ≥ 0.08). The differentiation between benign and malignant lesions was optimal (58.4 %) for the combination of b = 0 and 1,000 s/mm(2).
CONCLUSIONS
The wide variety of b value combinations applied in different studies significantly affects the ADC of breast lesions and confounds quantitative DWI. If only a couple of b values are used, those of b = 0 and 1,000 s/mm(2) are recommended for the best improvement of differentiating between benign and malignant lesions.
KEY POINTS
• The choice of b values significantly affects the ADC of breast lesions. • Sensitivity and specificity are not affected by the choice of b values. • b values 0 and 1,000 s/mm (2) are recommended for optimal differentiation between benign and malignant lesions. • Contrast medium prior to DWI does not significantly affect the ADC.
Topics: Breast; Breast Neoplasms; Contrast Media; Diffusion Magnetic Resonance Imaging; Female; Humans; Image Enhancement; Patient Admission; Predictive Value of Tests; Reproducibility of Results
PubMed: 25103535
DOI: 10.1007/s00330-014-3338-z -
Cancer Cell International Feb 2022Present work systematically reviewed relevant literature based on 18F-FDG PET parameters and conducted a meta-analysis to examine the prognostic value of maximal... (Review)
Review
Prognostic value of maximum standard uptake value, metabolic tumour volume, and total lesion glycolysis of 18F-FDG PET/CT in patients with malignant pleural mesothelioma: a systematic review and meta-analysis.
PURPOSE
Present work systematically reviewed relevant literature based on 18F-FDG PET parameters and conducted a meta-analysis to examine the prognostic value of maximal standard uptake value (SUVmax), total lesional glycolysis (TLG), and metabolic tumour volume (MTV) in the prognosis of malignant pleural mesothelioma (MPM).
METHODS
The relevant literature published in English were searched on PubMed, Cochrane Library, and EMBASE databases. We also evaluated the significance of SUVmax, TLG, and MTV in prognosis prediction using pooled hazard ratios (HRs).
RESULTS
The current study comprised 12 primary studies with a total of 1307 MPM cases. According to our results, the pooled HR (95% confidence interval [CI]) of increased SUVmax for overall survival (OS) was 1.30 (95% CI 1.13-1.49, P = 0.000), whereas the increased TLG was 1.81(95% CI 1.25-2.61, P = 0.089). The increased MTV was not significantly related to OS (1.14 [95% CI 0.87-1.50, P = 0.18]).However, study design-stratified subgroup analysis suggested that differences in OS of retrospective and prospective subgroups were statistically significant, and no significant heterogeneity among different studies was observed.
CONCLUSION
Based on the findings from the present work, PET/CT can significantly affect the prognosis prediction in MPM cases. Also, the increased SUVmax and TLG values predict an increased risk of mortality.
PubMed: 35114996
DOI: 10.1186/s12935-022-02482-5 -
Journal of the American Heart... Nov 2015Endothelial dysfunction plays a pivotal role in cardiovascular disease progression, and is associated with adverse events. The purpose of this systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Endothelial dysfunction plays a pivotal role in cardiovascular disease progression, and is associated with adverse events. The purpose of this systematic review and meta-analysis was to investigate the prognostic magnitude of noninvasive peripheral endothelial function tests, brachial artery flow-mediated dilation (FMD), and reactive hyperemia--peripheral arterial tonometry (RH-PAT) for future cardiovascular events.
METHODS AND RESULTS
Databases of MEDLINE, EMBASE, and the Cochrane Library were systematically searched. Clinical studies reporting the predictive value of FMD or RH-PAT for cardiovascular events were identified. Two authors selected studies and extracted data independently. Pooled effects were calculated as risk ratio (RR) for continuous value of FMD and natural logarithm of RH-PAT index (Ln_RHI) using random-effects models. Thirty-five FMD studies of 17 280 participants and 6 RH-PAT studies of 1602 participants were included in the meta-analysis. Both endothelial function tests significantly predicted cardiovascular events (adjusted relative risk [95% CI]: 1% increase in FMD 0.88 [0.84-0.91], P<0.001, 0.1 increase in Ln_RHI 0.79 [0.71-0.87], P<0.001). There was significant heterogeneity in the magnitude of the association across studies. The magnitude of the prognostic value in cardiovascular disease subjects was comparable between these 2 methods; a 1 SD worsening in endothelial function was associated with doubled cardiovascular risk.
CONCLUSIONS
Noninvasive peripheral endothelial function tests, FMD and RH-PAT, significantly predicted cardiovascular events, with similar prognostic magnitude. Further research is required to determine whether the prognostic values of these 2 methods are independent of each other and whether an endothelial function-guided strategy can provide benefit in improving cardiovascular outcomes.
Topics: Brachial Artery; Cardiovascular Diseases; Chi-Square Distribution; Diagnostic Techniques, Cardiovascular; Endothelium, Vascular; Fingers; Humans; Hyperemia; Manometry; Odds Ratio; Predictive Value of Tests; Prognosis; Regional Blood Flow; Risk Factors; Vasodilation
PubMed: 26567372
DOI: 10.1161/JAHA.115.002270 -
World Journal of Surgical Oncology May 2021The inflammatory biomarker "C-reactive protein to albumin ratio (CAR)" has been reported to significantly correlate to a variety of human cancers. However, there are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUNDS
The inflammatory biomarker "C-reactive protein to albumin ratio (CAR)" has been reported to significantly correlate to a variety of human cancers. However, there are conflicting results regarding the prognostic value of CAR in colorectal cancer. Previous studies mainly assessed patients in Eastern countries, so their findings may not be applicable to the Western population. Therefore, this updated meta-analysis aimed to investigate the prognostic value of pre-treatment CAR and outcomes of patients with colorectal cancer.
METHODS
We conducted a systematic search for eligible literature until October 31, 2020, using PubMed and Embase databases. Studies assessing pre-treatment CAR and outcomes of colorectal cancer were included. Outcome measures included overall survival, disease-free survival, progression-free survival, and clinicopathological features. The pooled hazard ratios (HR) with 95% confidence intervals (CI) were used as effective values.
RESULTS
A total of 15 studies involving 6329 patients were included in this study. The pooled results indicated that a high pre-treatment CAR was associated with poor overall survival (HR 2.028, 95% CI 1.808-2.275, p < 0.001) and poor disease-free survival/progression-free survival (HR 1.768, 95% CI 1.321-2.365, p < 0.001). Subgroup analysis revealed a constant prognostic value of the pre-treatment CAR despite different study regions, sample size, cancer stage, treatment methods, or the cut-off value used. We also noted a correlation between high pre-treatment CAR and old age, male sex, colon cancer, advanced stage (III/IV), large tumor size, poor differentiation, elevated carcinoembryonic antigen levels, neutrophil-to-lymphocyte ratio, and the modified Glasgow prognostic score.
CONCLUSIONS
High pre-treatment CAR was associated with poor overall survival, disease-free survival, and progression-free survival in colorectal cancer. It can serve as a prognostic marker for colorectal cancer in clinical practice.
Topics: C-Reactive Protein; Colonic Neoplasms; Colorectal Neoplasms; Humans; Male; Prognosis; Serum Albumin
PubMed: 33933070
DOI: 10.1186/s12957-021-02253-y -
Neurological Sciences : Official... Feb 2021The purpose of this meta-analysis was to assess the diagnosis and prognostic value of plasma copeptin levels after traumatic brain injury (TBI). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The purpose of this meta-analysis was to assess the diagnosis and prognostic value of plasma copeptin levels after traumatic brain injury (TBI).
METHODS
The databases PubMed, Cochrane Library, OvidSP, Google Scholar, VIP, CNKI, and WFSD were systematically searched from the inception dates to May 9, 2020. The pooled analysis of relevant data was conducted by the RevMan 5.3 software. Subgroups analysis was performed to explore the impact of age, country, male ratio, follow-up time, and Glasgow coma score (GCS) on the pooled area under curve (AUC) values of assessment mortality.
RESULTS
A total of 17 studies involving 2654 participants were included in the current meta-analysis. The pooled results demonstrated that increased plasma copeptin levels were significantly associated with TBI [SMD, 2.44; 95%CI, 1.59 ~ 3.29; P < 0.00001] and also were significantly associated with mortality [SMD, 1.37; 95%CI, 1.16 ~ 1.58; P < 0.00001], and poor functional outcomes (PFO) [SMD, 1.44; 95%CI, 1.20 ~ 1.68; P < 0.00001] in patients with TBI. Furthermore, the copeptin had a significant value in diagnosing brain concussion [AUC, 0.90; 95%CI, 0.84 ~ 0.95; P < 0.00001] and predicting progressive hemorrhagic injury [AUC, 0.83; 95%CI, 0.80 ~ 0.87; P < 0.00001], acute traumatic coagulopathy [AUC, 0.84; 95%CI, 0.79 ~ 0.89; P < 0.00001], mortality [AUC, 0.89; 95%CI, 0.87 ~ 0.92; P < 0.00001], and PFO [AUC, 0.88; 95%CI, 0.84 ~ 0.92; P < 0.00001] in patients with TBI. The subgroup analysis findings suggested that the age, country, male ratio, follow-up time, and GCS were not obvious factors influencing the pooled AUC values of assessment mortality.
CONCLUSIONS
The authors indicate that the plasma copeptin is a potentially promising biomarker for TBI diagnosis and prognosis prediction.
Topics: Area Under Curve; Brain Injuries, Traumatic; Glycopeptides; Humans; Male; Prognosis
PubMed: 33389249
DOI: 10.1007/s10072-020-05019-8 -
Oncotarget Feb 2019This study aimed to evaluate the diagnostic performance of arterial spin labelling (ASL) in grading of adult gliomas. Eighteen studies matched the inclusion criteria and...
This study aimed to evaluate the diagnostic performance of arterial spin labelling (ASL) in grading of adult gliomas. Eighteen studies matched the inclusion criteria and were included after systematic searches through EMBASE and MEDLINE databases. The quality of the included studies was assessed utilizing Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The quantitative values were extracted and a meta-analysis was subsequently based on a random-effect model with forest plot and joint sensitivity and specificity modelling. Hierarchical summary receiver operating characteristic (HROC) curve analysis was also conducted. The absolute tumour blood flow (TBF) values can differentiate high-grade gliomas (HGGs) from low-grade gliomas (LGGs) and grade II from grade IV tumours. However, it lacked the capacity to differentiate grade II from grade III tumours and grade III from grade IV tumours. In contrast, the relative TBF (rTBF) is effective in differentiating HGG from LGG and in glioma grading. The maximum rTBF (rTBFmax) demonstrated the best results in glioma grading. These results were also reflected in the sensitivity/specificity analysis in which the rTBFmax showed the highest discrimination performance in glioma grading. The estimated effect size for the rTBF was approximately similar between HGGs and LGGs, and grade II and grade III tumours, (-1.46 (-2.00, -0.91), -value < 0.001), (-1.39 (-1.89, -0.89), -value < 0.001), respectively; while it exhibited smaller effect size between grade III and grade IV (-1.05 (-1.82, -0.27)), < 0.05). Sensitivity and specificity analysis replicate these results as well. This meta-analysis suggests that ASL is useful for glioma grading, especially when considering the rTBFmax parameter.
PubMed: 30899427
DOI: 10.18632/oncotarget.26674 -
European Journal of Trauma and... Jun 2023Over the years, blood biomarkers have been extensively applied for diagnostic and prognostic assessment of traumatic brain injury (TBI). Herein, we conducted a... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Over the years, blood biomarkers have been extensively applied for diagnostic and prognostic assessment of traumatic brain injury (TBI). Herein, we conducted a meta-analysis to evaluate the diagnostic and prognostic value of glial fibrillary acidic protein (GFAP) for TBI patients.
METHODS
The online databases, including PubMed, Embase, Cochrane Library, CNKI, and WFSD, were systematically retrieved from inception until May 2021. The RevMan 5.3 software and Stata 15 were used to conduct data analysis.
RESULTS
A total of 22 eligible studies comprising 3709 patients were included in this meta-analysis. The pooled results indicated that serum GFAP had a diagnostic value in detecting traumatic intracranial lesions (AUC 0.81; 95% CI 0.77-0.84; p < 0.00001). The pooled sensitivity and specificity were 0.93 (95% CI 0.81-0.98), and 0.66 (95% 0.53-0.77; p < 0.00001), respectively. For assessment of unfavorable outcome, the pooled sensitivity, specificity and AUC value were 0.66 (95% CI 0.54-0.76; p < 0.00001), 0.82(95% CI 0.72-0.90; p < 0.00001), and 0.82 (95% CI 0.76-0.88; p < 0.00001), respectively. Besides, GFAP exhibited a significant value in predicting mortality (AUC 0.81; 95% CI 0.77-0.84; p < 0.00001), with high sensitivity and specificity (0.86, 95% CI 0.79-0.92, p < 0.00001, and 0.66, 95% CI 0.52-0.77, p < 0.00001). The subgroup analysis indicated that the type of TBI and cut-off value were potential sources of heterogeneity, which influenced the pooled AUC values for mortality prediction.
CONCLUSIONS
Our meta-analysis indicated that GFAP had diagnostic and prognostic value for TBI patients, especially during the early TBI.
Topics: Humans; Prognosis; Glial Fibrillary Acidic Protein; Brain Injuries, Traumatic; Biomarkers; Sensitivity and Specificity
PubMed: 35525877
DOI: 10.1007/s00068-022-01979-y -
Cancer Cell International 2019The mammalian homologs of Lin-28, Lin28 (also called Lin28A) and Lin28B, are promising cancer biomarkers. This meta-analysis was performed to evaluate the prognostic...
BACKGROUND
The mammalian homologs of Lin-28, Lin28 (also called Lin28A) and Lin28B, are promising cancer biomarkers. This meta-analysis was performed to evaluate the prognostic values of Lin28A and Lin28B in multiple human malignancies.
METHODS
Systematic searches of the PubMed, Web of Science and Embase were used to identify relevant studies. Pooled hazard ratios (HRs) with 95% confidence intervals (CI) for overall survival (OS), recurrence-free survival (RFS), disease-free survival (DFS), or progression-free survival (PFS) were respectively calculated.
RESULTS
3772 Lin28A-associated patients and 1730 Lin28B-related cases were ultimately enrolled in this meta-analysis. The elevated expression level of Lin28A was significantly associated with poor OS (HR = 1.60, P < 0.001) and poor RFS/DFS/PFS (HR = 1.62, P < 0.001) in patients with malignancies. Lin28B overexpression significantly correlated with unfavorable OS (HR = 1.72, P < 0.001) and RFS/DFS/PFS (HR = 2.35, P < 0.001) of human malignancies.
CONCLUSIONS
Lin28A and Lin28B possess significant prognostic values in various human malignancies. Overexpression of Lin28A or Lin28B suggests poor prognosis for cancer patients.
PubMed: 30976203
DOI: 10.1186/s12935-019-0788-z -
International Journal of Stroke :... Oct 2015The association of blood pressure levels during the acute phase of ischemic stroke with outcome remains controversial. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The association of blood pressure levels during the acute phase of ischemic stroke with outcome remains controversial.
AIMS
The objective of this systematic review is to assess the predictive value for stroke outcome assessed by the modified Rankin scale score of systolic and diastolic blood pressure, measured by ambulatory blood pressure monitoring methods during the acute phase of ischemic stroke, compared with the values of casually derived blood pressure measurement on admission.
METHODS
We searched for studies with patients admitted within 24 h of stroke onset, and who had ambulatory blood pressure monitoring during the first 24 h of admission. We identified studies that reported blood pressure in those with good outcome and in those with poor outcome at end of follow-up, and performed a meta-analysis of the effect of mean blood pressure on outcome.
RESULTS
High systolic and diastolic blood pressure levels derived with ambulatory blood pressure monitoring were associated with poor short-, medium-, and long-term outcome, but the same was not found for casual blood pressure measurements. An increase in systolic blood pressure of 9·1 mmHg (95% confidence interval: 6·6-11·6, P < 0·001; I(2) = 9%) and an increase in diastolic blood pressure of 2·3 mmHg (95% confidence interval: 0·8-3·7, P = 0·002; I(2) = 0%) were associated with poor outcome.
CONCLUSIONS
Higher systolic and diastolic blood pressure levels derived with ambulatory blood pressure monitoring were associated with poor outcome. The same was not found for higher casual blood pressure measurements on admission, and it is possible that ambulatory blood pressure monitoring conveys better prognostic information.
Topics: Blood Pressure; Brain Ischemia; Databases, Bibliographic; Humans; Stroke; Time Factors
PubMed: 26283262
DOI: 10.1111/ijs.12609 -
BMC Infectious Diseases Nov 2023The neutrophil to lymphocyte ratio (NLR), an inflammatory biomarker, measures innate-adaptive immune system balance. In this systematic review and meta-analysis, we aim... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
The neutrophil to lymphocyte ratio (NLR), an inflammatory biomarker, measures innate-adaptive immune system balance. In this systematic review and meta-analysis, we aim to analyze the current literature to evaluate the diagnostic role of NLR in neonatal sepsis.
METHODS
PubMed, Web of Science, and Scopus were used to conduct a systematic search for relevant publications published before May 14, 2022.
RESULTS
Thirty studies, including 2328 neonates with sepsis and 1800 neonates in the control group, were included in our meta-analysis. The results indicated that NLR is higher in neonates with sepsis compared to healthy controls (SMD = 1.81, 95% CI = 1.14-2.48, P-value < 0.001) in either prospective (SMD = 2.38, 95% CI = 1.40-3.35, P-value < 0.001) or retrospective studies (SMD = 0.87, 95% CI = 0.63-1.12, P-value < 0.001) with a pooled sensitivity of 79% (95% CI = 62-90%), and a pooled specificity of 91% (95% CI = 73-97%). Also, we found that NLR is higher in neonates with sepsis compared to those who were suspected of sepsis but eventually had negative blood cultures (SMD =1.99, 95% CI = 0.76-3.22, P-value = 0.002) with a pooled sensitivity of 0.79% (95% CI = 0.69-0.86%), and a pooled specificity of 73% (95% CI = 54-85%). In addition, neonates with sepsis had elevated levels of NLR compared to other ICU admitted neonates (SMD = 0.73, 95% CI = 0.63-0.84, P < 0.001). The pooled sensitivity was 0.65 (95% CI, 0.55-0.80), and the pooled specificity was 0.80 (95% CI, 0.68-0.88).
CONCLUSION
Our findings support NLR as a promising biomarker that can be readily integrated into clinical settings to aid in diagnosing neonatal sepsis. As evidenced by our results, restoring balance to the innate and adaptive immune system may serve as attractive therapeutic targets. Theoretically, a reduction in NLR values could be used to measure therapeutic efficacy, reflecting the restoration of balance within these systems.
Topics: Infant, Newborn; Humans; Neutrophils; Neonatal Sepsis; Retrospective Studies; Prospective Studies; Lymphocytes; Biomarkers; Sepsis
PubMed: 38012554
DOI: 10.1186/s12879-023-08800-0