Detection of glioma recurrence by 11C-methionine positron emission tomography and dynamic susceptibility contrast-enhanced magnetic resonance imaging: a meta-analysis

Purpose This study aimed to compare the diagnostic value of C-11-methionine (C-11-MET) PET and dynamic susceptibility contrast-enhanced (DSCE) MRI in detecting glioma recurrence by meta-analysis. Materials and methods Databases such as PubMed (MEDLINE included), EMBASE, ScienceDirect, Springerlink, EBSCO, and Cochrane Database of Systematic Review were searched for relevant original articles on the detection of recurrent glioma using DSCE MRI or C-11-MET PET with or without computed tomography. No restriction was imposed over the types and grades of glioma. The included studies were assessed for methodological quality. Results from histopathological analysis and/or close clinical and/or radiological follow-up for at least 3 months were used as the reference standard. The data were extracted by two reviewers independently to analyze the sensitivity, specificity, summary receiver-operating characteristic curve, area under the curve, and heterogeneity. Results The present study analyzed a total of 17 selected articles including different types and grades of glioma and showed that C-11-MET PET and DSCE MRI had comparable sensitivity (0.870 and 0.884, respectively), specificity (0.813 and 0.853, respectively), positive likelihood ratio (4.355 and 5.806, respectively), negative likelihood ratio (0.192 and 0.134, respectively), and diagnostic odds ratio (21.857 and 41.918, respectively) without statistically significant differences, except for the fact that DSCE MRI displayed higher area under the curve and Q* index compared with C-11-MET PET (P<0.05). Conclusion Both C-11-MET PET and DSCE MRI are accurate tools for detecting glioma recurrence. Although DSCE MRI seems to be superior to C-11-MET PET, the latter can also be used to assess glioma recurrence when the former is not available.