Diffusion‑weighted magnetic resonance imaging for the detection of metastatic lymph nodes in patients with lung cancer: A meta‑analysis

Chen,Guang‑Xiang; Wang,Mao‑Hua; Zheng,Ting; Tang,Guang‑Cai; Han,Fu‑Gang; Tu,Guo‑Jian

doi:10.3892/mco.2017.1153

Diffusion‑weighted magnetic resonance imaging for the detection of metastatic lymph nodes in patients with lung cancer: A meta‑analysis

Authors:
- Guang‑Xiang Chen
- Mao‑Hua Wang
- Ting Zheng
- Guang‑Cai Tang
- Fu‑Gang Han
- Guo‑Jian Tu
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Affiliations: Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
Published online on: February 6, 2017 https://doi.org/10.3892/mco.2017.1153
Pages: 344-354
Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present meta‑analysis was to evaluate the diagnostic value of diffusion‑weighted imaging (DWI) in differentiating metastatic from non‑metastatic lymph nodes in patients with lung cancer. A systematic literature search was performed to identify eligible original studies. The quality of included studies was assessed using ‘quality assessment of diagnostic accuracy studies’ (QUADAS‑2). Meta‑analysis was performed to pool sensitivity and specificity, to calculate the positive likelihood ratio (PLR), the negative likelihood ratio (NLR) and the diagnostic odds ratio (DOR), and to construct the summary receiver operating characteristic (SROC) curve. The homogeneity, threshold effect and publication bias were also investigated. Meta‑regression analysis was performed to identify the sources of heterogeneity. A total of 10 studies with 11 datasets met the inclusion criteria, which comprised 796 patients with a total of 2,433 lymph nodes. The pooled diagnostic sensitivity was 0.78 [95% confidence interval (CI): 0.74‑0.81] and the pooled diagnostic specificity was 0.88 (95% CI: 0.86‑0.89). The PLR, NLR, and DOR were 7.11 (95% CI: 4.39‑11.52), 0.24 (95% CI: 0.18‑0.33), and 31.14 (95% CI: 17.32‑55.98), respectively. The area under the SROC curve was 0.90. No publication bias was found (bias=‑0.15, P=0.887). Notable heterogeneity was, however, observed, and patient selection, type of lung cancer, number of enrolled lymph nodes, reference standard, B‑value and the type of scanner were the sources of heterogeneity (P<0.05). No significant threshold effect was identified (P=0.537). In conclusion, DWI has been revealed to be a valuable magnetic resonance imaging (MRI) modality, with good diagnostic performance for distinguishing metastatic from non‑metastatic lymph nodes in patients with lung cancer. Therefore, DWI may be a useful supplement to conventional MRI techniques.

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