RESUMO
No clear conclusions have yet been reached regarding the accuracy of magnetic resonance imaging (MRI) radiomics in distinguishing high-grade glioma (HGG) from low-grade glioma (LGG). In the present study, a meta-analysis was conducted to determine the diagnostic value of MRI radiomics in differentiating between HGG and LGG, in order to guide their clinical diagnosis. PubMed, Embase and the Cochrane Library databases were searched up to November 2022. The search included studies in which true positive, false positive, true negative and false negative values for the differentiation of HGG from LGG were reported or could be calculated by retrograde extrapolation. Duplicate publications, research without full text, studies with incomplete information or unextractable data, animal studies, reviews and systematic reviews were excluded. STATA 15.1 was used to analyze the data. The meta-analysis included 15 studies, which comprised a total of 1,124 patients, of which 701 had HGG and 423 had LGG. The pooled sensitivity and specificity of the studies overall were 0.92 (95% CI: 0.89-0.95) and 0.89 (95% CI: 0.85-0.92), respectively. The positive and negative likelihood ratios of the studies overall were 7.89 (95% CI: 6.01-10.37) and 0.09 (95% CI: 0.07-0.12), respectively. The pooled diagnostic odds ratio of the studies was 85.20 (95% CI: 54.52-133.14). The area under the summary receiver operating characteristic curve was 0.91. These findings indicate that radiomics may be an accurate tool for the differentiation of glioma grades. However, further research is needed to verify the most appropriate of these technologies.
RESUMO
BACKGROUND: Since there is still controversy about the comparison of the efficacy and safety of RH and RFA in the treatment of recurrent liver cancer, we conducted a meta-analysis to compare the efficacy and safety, in order to provide evidence-based evidence for future research and clinical treatment. METHODS: We searched PubMed, Embase, and Cochrane Library from the establishment of the database to Feb 2021. We included studies that reported liver cancer patients underwent repeated hepatectomy (RH) or radiofrequency ablation (RFA), and we excluded duplicate publications, research without full text, incomplete information, or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. The STATA 15.1 was used to analyze the data. RESULTS: The pooled results show that the 3-year and 5-year overall survival (OS) rate of the repeated hepatectomy group was significantly higher than the radiofrequency ablation group (odds ratio (OR) = 1.95, 95% confidence interval (CI):1.47-2.60, P ≤ 0.001; OR = 1.65, 95% CI: 1.12-2.43, P = 0.012). Similarly, the pooled results show that the 3-year and 5-year disease-free survival (DFS) rate of the repeated hepatectomy group was significantly higher than the radiofrequency ablation group (OR = 1.73, 95% CI: 1.30-2.31, P ≤ 0.001; OR = 1.84, 95% CI: 1.38-2.49, P ≤ 0.001). However, there is no significant difference in the 1-year OS and DFS rate of repeated hepatectomy group and radiofrequency ablation group. Additionally, the pooled results show that the postoperative Clavien-Dindo (CD) grade II or higher complication rate of the repeated hepatectomy group was significantly higher than the radiofrequency ablation group (OR = 2.80, 95% CI: 1.37-5.75, P = 0.005). CONCLUSION: Based on the pooled results of 8 existing retrospective studies, RH has a higher OS rate and DFS rate in the treatment of recurrent liver cancer, while the postoperative complication rate of RFA is lower. When survival is the primary goal, RH should be the first choice for recurrent liver cancer.