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PloS One 2014Differentiation of high-grade gliomas and solitary brain metastases is an important clinical issue because the treatment strategies differ greatly. Our study aimed to... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Differentiation of high-grade gliomas and solitary brain metastases is an important clinical issue because the treatment strategies differ greatly. Our study aimed to investigate the potential value of diffusion tensor imaging (DTI) in differentiating high-grade gliomas from brain metastases using a meta-analytic approach.
MATERIALS AND METHODS
We searched Pubmed, Embase and the Cochrane Library for relevant articles published in English. Studies that both investigated high-grade gliomas and brain metastases using DTI were included. Random effect model was used to compare fractional anisotropy (FA) and mean diffusivity (MD) values in the two tumor entities.
RESULTS
Nine studies were included into the meta-analysis. In the peritumoral region, compared with brain metastases, high-grade gliomas had a significant increase of FA (SMD = 0.47; 95% CI, 0.22-0.71; P<0.01) and a significant decrease of MD (SMD = -1.49; 95% CI, -1.91 to -1.06; P<0.01). However, in the intratumoral area, no significant change in FA (SMD = 0.16; 95% CI, -0.49 to 0.82; P = 0.73) or MD (SMD = 0.34; 95% CI, -0.91 to 1.60; P = 0.59) was detected between gliomas and metastases.
CONCLUSIONS
High-grade gliomas may be distinguished from brain metastases by comparing the peritumoral FA and MD values. DTI appears to be a promising tool in diagnosing solitary intracranial lesions.
Topics: Anisotropy; Brain; Brain Neoplasms; Diagnosis, Differential; Diffusion Tensor Imaging; Glioma; Humans; Reproducibility of Results; Sensitivity and Specificity
PubMed: 25380185
DOI: 10.1371/journal.pone.0112550 -
Heart Failure Reviews Sep 2018T1 mapping and extracellular volume (ECV) fraction are useful new magnetic resonance imaging (MRI) techniques to evaluate myocardial fibrosis; however, their prognostic... (Meta-Analysis)
Meta-Analysis
T1 mapping and extracellular volume (ECV) fraction are useful new magnetic resonance imaging (MRI) techniques to evaluate myocardial fibrosis; however, their prognostic value has not been well described. In this study, a systematic review and meta-analysis evaluating the prognostic value of these techniques is performed in patients with ischemic and non-ischemic cardiomyopathy. PubMed, Cochrane CENTRAL, and Meta-Register of Controlled Trials were searched for studies that utilized T1 mapping and ECV and that also had ≥ 12 months of follow-up data. The primary endpoints included were cardiovascular death and non-fatal cardiac events (heart failure, acute coronary syndrome). Six studies involving a total of 1524 patients and a mean follow-up of 26.3 months were included. Patients had a mean age of 57.6 years and 56.5% were male. Summary effect estimates were generated with fixed/random-effects modeling and hazard ratios were assessed. Patients with a higher ECV value had a significantly higher incidence of cardiovascular death (hazard ratio [HR] 1.79 [95% CI 1.24 to 2.58; P = 0.09) and combined cardiac events (HR 1.11 [95% CI 1.08-1.15]; P < 0.0001). Patients with higher native T1 values and (HR 1.06 [95% CI 0.96 to 1.17]; P = 0.27) and lower post contrast T1 value (HR 0.99 [95% CI 0.98-0.99], P < 0.001) overall had no increased risk for cardiovascular events. Comparing with other CMR parameters, ECV has excellent potential prognostic value and can help guide risk stratification of patients with ischemic or non-ischemic cardiomyopathy into high and low risk for adverse cardiovascular events.
Topics: Cardiomyopathies; Extracellular Matrix; Humans; Magnetic Resonance Imaging, Cine; Myocardium; Prognosis
PubMed: 29968223
DOI: 10.1007/s10741-018-9718-8 -
Journal of Clinical Medicine Oct 2022Background: To assess the diagnostic utility of middle meatal culture (MMC) in patients with acute and chronic sinusitis; Methods: Six databases were thoroughly reviewed... (Review)
Review
Background: To assess the diagnostic utility of middle meatal culture (MMC) in patients with acute and chronic sinusitis; Methods: Six databases were thoroughly reviewed up to March 2022. Sensitivity, specificity, and negative and positive predictive values were extracted. Methodological quality was evaluated using the QUADAS-2 instrument; Results: Fifteen reports were analyzed. MMC results exhibited a significant correlation (r = 0.7590, 95% confidence interval [CI] [0.6855; 0.8172], p < 0.0001) with those of maxillary sinus puncture. The diagnostic odds ratio (DOR) of MMC (reference = maxillary sinus culture) was 8.5475 [3.9238; 18.6199]. The area under the summary receiver operating characteristic curve was 0.761. The sensitivity and specificity of MMC were 0.7759 [0.6744; 0.8526] and 0.7514 [0.6110; 0.8534], respectively. We performed subgroup analysis based on age (children vs. adults), duration of disease (acute vs. chronic), and specimen collection method (biopsy, swabs, suction tips). The DORs, specificities, and negative and positive predictive values varied significantly. Diagnostic accuracy was highest for children and individuals with chronic disease, and when samples were collected via suction.; Conclusions: MMC provided fair diagnostic accuracy in patients with acute or chronic sinusitis. Although some institutional differences were evident, the middle meatal and maxillary sinus culture results were similar.
PubMed: 36294389
DOI: 10.3390/jcm11206069 -
Journal of Cancer 2019Growing evidence suggests pretreatment fibrinogen can serve as a prognostic marker in various malignancies. However, there are contradictory results about the...
Growing evidence suggests pretreatment fibrinogen can serve as a prognostic marker in various malignancies. However, there are contradictory results about the prognostic role of fibrinogen in urological cancers. We conducted a meta-analysis to evaluate the association between pretreatment plasma fibrinogen and survival outcomes in urological cancers. After a systematic search of PubMed and Embase, we included 14 studies in our meta-analysis, and estimated hazard ratios (HRs) for overall survival (OS) and cancer-specific survival (CSS) using a fixed-effect model. Our results indicate that pretreatment plasma fibrinogen is a prognostic factor in urological cancers (OS: HR=2.21, 95% CI=1.91-2.57, P<0.001, CSS: HR=2.67, 95% CI=2.23-3.19, P<0.001). Elevated pretreatment plasma fibrinogen is associated with poorer survival in prostate cancer (OS: HR=2.26, 95% CI=1.47-3.48, P<0.001; CSS: HR=2.42, 95% CI=1.44-4.07, P=0.001), renal cell carcinoma (OS: HR=2.13, 95% CI=1.75-2.61, P<0.001; CSS: HR=2.99, 95% CI=2.29-3.89, P<0.001) and upper tract urothelial carcinoma (OS: HR=2.34, 95% CI=1.81-3.02, P<0.001; CSS: HR=2.43, 95% CI=1.84-3.20, P<0.001). Subgroup analyses showed that plasma fibrinogen has a more negative impact on survival in Caucasian patients (OS: HR=2.52, 95% CI=1.95-3.25, P<0.001; CSS: HR=2.83, 95% CI=1.92-4.17, P<0.001) than Asian patients (OS: HR=2.07, 95% CI=1.73-2.49, P<0.001; CSS: HR=2.63, 95% CI=2.14-3.22, P<0.001). The prognostic value of fibrinogen is also consistent when stratified by different cut-off values. These results show that high pretreatment plasma fibrinogen levels can predict poorer OS and CSS in patients with urological cancers.
PubMed: 30719143
DOI: 10.7150/jca.26989 -
La Radiologia Medica May 2023The aim of the present systematic review and meta-analysis is to assess the accuracy of automated landmarking using deep learning in comparison with manual tracing for... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of the present systematic review and meta-analysis is to assess the accuracy of automated landmarking using deep learning in comparison with manual tracing for cephalometric analysis of 3D medical images.
METHODS
PubMed/Medline, IEEE Xplore, Scopus and ArXiv electronic databases were searched. Selection criteria were: ex vivo and in vivo volumetric data images suitable for 3D landmarking (Problem), a minimum of five automated landmarking performed by deep learning method (Intervention), manual landmarking (Comparison), and mean accuracy, in mm, between manual and automated landmarking (Outcome). QUADAS-2 was adapted for quality analysis. Meta-analysis was performed on studies that reported as outcome mean values and standard deviation of the difference (error) between manual and automated landmarking. Linear regression plots were used to analyze correlations between mean accuracy and year of publication.
RESULTS
The initial electronic screening yielded 252 papers published between 2020 and 2022. A total of 15 studies were included for the qualitative synthesis, whereas 11 studies were used for the meta-analysis. Overall random effect model revealed a mean value of 2.44 mm, with a high heterogeneity (I = 98.13%, τ = 1.018, p-value < 0.001); risk of bias was high due to the presence of issues for several domains per study. Meta-regression indicated a significant relation between mean error and year of publication (p value = 0.012).
CONCLUSION
Deep learning algorithms showed an excellent accuracy for automated 3D cephalometric landmarking. In the last two years promising algorithms have been developed and improvements in landmarks annotation accuracy have been done.
Topics: Humans; Deep Learning; Anatomic Landmarks; Reproducibility of Results; Cephalometry; Imaging, Three-Dimensional; Algorithms
PubMed: 37093337
DOI: 10.1007/s11547-023-01629-2 -
Medicine Nov 2018Autophagy is a mechanism which relies on lysosomes for clearance and recycling of abnormal proteins or organelles. Many studies have demonstrated that the deregulation... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Autophagy is a mechanism which relies on lysosomes for clearance and recycling of abnormal proteins or organelles. Many studies have demonstrated that the deregulation of autophagy is associated with the development of various diseases including cancer. The use of autophagy inhibitors is an emerging trend in cancer treatment. However, the value of autophagy inhibitors remains under debate. Thus, a meta-analysis was performed, aiming to evaluate the clinical value of autophagy-inhibitor-based therapy.
METHODS
We searched for clinical studies that evaluated autophagy-inhibitor-based therapy in cancer. We extracted data from these studies to evaluate the relative risk (RR) of overall response rate (ORR), 6-month progression-free survival (PFS) rate, and 1-year overall survival (OS) rate.
RESULTS
Seven clinical trials were identified (n = 293). Treatments included 2 combinations of hydroxychloroquine and gemcitabine, 1 combination of hydroxychloroquine and doxorubicin, 1 combination of chloroquine and radiation, 2 combinations of chloroquine, temozolomide, and radiation, and 1 hydroxychloroquine monotherapy. Autophagy-inhibitor-based therapy showed higher ORR (RR: 1.33, 95% confidence interval [CI]: 0.95-1.86, P = .009), PFS (RR: 1.72, 95% CI: 1.05-2.82, P = .000), OS (RR: 1.39, 95% CI: 1.11-1.75, P = .000) values than the therapy without inhibiting autophagy.
CONCLUSION
This meta-analysis showed that autophagy-inhibitor-based therapy has better treatment response compared to chemotherapy or radiation therapy without inhibiting autophagy, which may provide a new strategy for the treatment of cancers.
Topics: Antineoplastic Combined Chemotherapy Protocols; Autophagy; Chloroquine; Clinical Trials as Topic; Dacarbazine; Deoxycytidine; Doxorubicin; Humans; Hydroxychloroquine; Neoplasms; Risk; Temozolomide; Treatment Outcome; Gemcitabine
PubMed: 30431566
DOI: 10.1097/MD.0000000000012912 -
Frontiers in Cardiovascular Medicine 2021Biomarkers such as B-type natriuretic peptide (BNP), N-terminal pro-BNP (NT-proBNP), cardiac troponin (cTn), and CK-MB contribute significantly to the diagnosis of...
Biomarkers such as B-type natriuretic peptide (BNP), N-terminal pro-BNP (NT-proBNP), cardiac troponin (cTn), and CK-MB contribute significantly to the diagnosis of cardiovascular disease (CVD). Recent studies have demonstrated that suppression of tumorigenicity 2 (ST2) is associated with CVD, but a meta-analysis of ST2 levels in different CVDs has yet to be conducted. Therefore, the present study aimed to investigate soluble ST2 (sST2) levels in patients with ischemic heart disease (IHD), myocardial infarction (MI), and heart failure (HF). A total of 1,425 studies were searched across four databases, of which 16 studies were included in the meta-analysis. The Newcastle-Ottawa Quality Assessment Scale (NOS) values of all 16 studies were ≥7. The meta-analysis results indicated that the sST2 level was not correlated with IHD (standard mean difference [SMD] = 0.58, 95% confidence interval [95% CI] = 0.00 to 1.16, = 0.05) or MI (weighted mean difference [WMD] = 0.17, 95% CI = -0.22 to 0.55, = 0.40) but was significantly associated with HF (WMD = 0.21, 95% CI = 0.04 to 0.38, = 0.02; = 99%, < 0.00001). sST2 levels did not differ significantly between patients with IHD or MI and healthy individuals; however, we believe that ST2 could be used as an auxiliary diagnostic biomarker of HF.
PubMed: 34368254
DOI: 10.3389/fcvm.2021.697837 -
Laryngoscope Investigative... Apr 2022The aim of this systematic review and meta-analysis was to investigate the association between obstructive sleep apnea (OSA) and erythrocytosis. (Review)
Review
OBJECTIVE
The aim of this systematic review and meta-analysis was to investigate the association between obstructive sleep apnea (OSA) and erythrocytosis.
METHODS
The PubMed, Web of Science, and Cochrane Library databases were searched for articles examining hematocrit values in patients with OSA and control individuals published till September 1, 2021. The pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated, and subgroup analyses were performed.
RESULTS
Eleven eligible studies with a total of 4608 patients with OSA were included in this meta-analysis. Pooled outcomes revealed that hematocrit values were significantly higher in patients with OSA than in controls (SMD, 0.19; 95% CI, 0.08-0.29; < .01). When studies were stratified by disease severity, the significant differences in hematocrit values between patients and controls were only observed in the severe OSA group (SMD, 0.34; 95% CI, 0.08-0.59; < .01), but not in the mild and moderate OSA groups. In subgroup analyses according to sex and publication year, significant differences in hematocrit values between patients and controls remained stable in studies with only female patients (SMD, 0.25; 95% CI, 0.12-0.38; < .01) and in studies published after 2012 (SMD, 0.17; 95% CI, 0.06-0.28, < .01).
CONCLUSION
Our meta-analysis revealed that the hematocrit value was significantly increased in patients with OSA, particularly in severe patients, compared with that in controls. However, the elevation was modest, and the hematocrit value is expected to be within the normal range in patients with OSA. These data suggest that OSA leads to slight increases in hematocrit but does not cause clinically significant erythrocytosis.
PubMed: 35434329
DOI: 10.1002/lio2.751 -
The British Journal of Radiology Jul 2021We undertook a systematic review and meta-analysis of the diagnostic performance of mean apparent diffusion coefficient (ADC) values derived by diffusion-weighted... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
We undertook a systematic review and meta-analysis of the diagnostic performance of mean apparent diffusion coefficient (ADC) values derived by diffusion-weighted (DW)-MRI in the characterization of solid benign and malignant liver lesions, and to assess their value in discriminating these lesions in daily routine practice.
METHODS
A systematic review of PubMed, Embase, Scopus, and Web of Science was conducted to retrieve studies that used ADC values for differentiating solid benign/dysplastic nodules and malignant liver lesions. A bivariate random-effects model with pooled sensitivity and specificity values with 95% CI (confidence interval) was used. This meta-analysis was performed on the per-lesion basis. Summary receiver operating characteristic (SROC) plot and area under curve (AUC) were created.
RESULTS
A total of 14 original articles were retrieved. The combined (95% CI) sensitivity and specificity of mean ADC values for differentiating solid benign from malignant lesions were 78% (67-86%) and 74% (64-81%), respectively. The pooled (95% CI) positive and negative LRs were respectively 3 (2.3-3.8) and 0.3 (0.21-0.43). The DOR (95% CI) was 10 (7-15). The AUC (95% CI) of the SROC plot was 82% (78-85%). Reporting bias was negligible ( value of regression test = 0.36). Mean size of malignant lesions and breathing pattern of MRI were found to be sources of heterogeneity of pooled sensitivity.
CONCLUSION
ADC measurement independently may not be an optimal diagnostic imaging method for differentiating solid malignant from solid benign hepatic lesions. The meta-analysis showed that ADC measurement had moderate diagnostic accuracy for characterizing solid liver lesions. Further prospective and comparative studies with pre-specified ADC thresholds could be performed to investigate the best MRI protocol and ADC threshold for characterizing solid liver lesions.
ADVANCES IN KNOWLEDGE
ADC measurement by DW-MRI does not have a good diagnostic performance to differentiate solid malignant from solid benign lesions. Therefore, we suggest not using ADC values in clinical practice to evaluate solid liver lesions.
Topics: Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Humans; Liver Neoplasms; Sensitivity and Specificity
PubMed: 34111960
DOI: 10.1259/bjr.20210059 -
PloS One 2016Recently, many studies have shown that the serum lactate dehydrogenase (LDH) level is related to the prognosis of renal cell carcinoma (RCC). We launched this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Recently, many studies have shown that the serum lactate dehydrogenase (LDH) level is related to the prognosis of renal cell carcinoma (RCC). We launched this meta-analysis to assess the prognostic value of serum LDH in patients with RCC.
METHODS
We searched PubMed, Embase and Web of Science for information on serum LDH and the outcome of RCC through June 14, 2016. The hazard ratio (HR) and its 95% confidence interval (CI) for overall survival (OS) and progression-free survival (PFS) were extracted and integrated from the matching studies.
RESULTS
A total of 29 studies including 6629 patients with RCC were incorporated in this meta-analysis. Patients whose serum LDH levels were elevated had a lower OS (HR = 2.13, 95% CI = 1.69-2.69, P < 0.001). Meanwhile, the pooled data showed that a higher serum LDH level was a negative prognostic factor for PFS (HR = 1.74, 95% CI = 1.48-2.04, P < 0.001). Furthermore, subgroup analyses indicated elevated serum LDH was associated with poor survival in different tumor types. Elevated serum LDH was significantly associated with worse prognosis for patients with all stages of RCC (OS, HR = 2.41, 95% CI = 1.09-5.33), metastatic RCC (OS, HR = 2.62, 95% CI 1.57-2.59; CSS, HR = 1.79, 95% CI 1.49-2.15), and non-metastatic RCC (OS, HR = 3.67, CI = 1.33-10.13). Besides, elevated serum LDH also indicated a worse prognosis in subgroups of cut-off values, analysis types and ethnicity.
CONCLUSIONS
Our results show that serum LDH levels are associated with the outcomes of RCC and can be used as a valuable biomarker for monitoring prognoses.
Topics: Biomarkers, Tumor; Carcinoma, Renal Cell; Humans; Kidney Neoplasms; L-Lactate Dehydrogenase; Proportional Hazards Models; Publication Bias; ROC Curve
PubMed: 27861542
DOI: 10.1371/journal.pone.0166482