Value of Intra-operative Ultrasound in Diagnosis of Tumor Residue after Resection of Intracranial Gliomas: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 GAOYing , GAOJun-xi ,  YAOLan-hui

Department of Ultrasound Diagnostic, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China;

Corresponding author：

YAOLan-hui, Email: yaolanhui6082@yahoo.com.cn

Keywords：

Intra-operative ultrasound; Gliomas; Residue; Meta-analysis; Diagnostic test

DOI：

10.7507/1672-2531.20140098

Video：

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Objective To systematically review the value of intra-operative ultrasound in diagnosis of tumor residue after resection of intracranial gliomas. Methods Such databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP were electronically searched for the diagnostic test about intra-operative ultrasound in diagnosis of tumor residue after resection of intracranial gliomas by March 31st, 2013. Meanwhile, search engines such as Google, Baidu were also used for relevant search. According to the inclusion and exclusion criteria, the literature was screened and the data were extracted. The methodological quality was evaluated in accordance with the quality assessment tool for diagnostic accuracy studies (QUADAS) and then meta-analysis was conducted using Meta-DiSc 1.4 software. Results A total of 10 studies involving 423 patients were included. The results of meta-analysis showed that the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio (DOR) were 0.78 (95%CI 0.74 to 0.82), 0.90 (95%CI 0.88 to 0.90), 5.12 (95%CI 2.86 to 9.16), 0.29 (95%CI 0.21 to 0.39) and 25.00 95%CI (13.27 to 47.10), respectively; and the AUC was 0.89. In the subgroup analysis, for low grade intracranial gliomas, the results of meta-analysis showed that the sensitivity, specificity and DOR were 0.87 (95%CI 0.77 to 0.94), 0.88 (95%CI 0.78 to 0.94) and 28.93 (95%CI 7.46 to 112.14), respectively, and the AUC was 0.92. For high grade gliomas, the results of meta-analysis showed that the sensitivity, specificity and DOR were 0.80 (95%CI 0.72 to 0.87), 0.67 (95%CI 0.53 to 0.79) and 7.20 (95%CI 3.04 to 17.09), respectively, and the AUC was 0.80. Conclusion Intra-operative ultrasound is useful for the diagnosis of tumor residue after resection of intracranial gliomas, especially for low grade gliomas.

Citation： GAOYing, GAOJun-xi, YAOLan-hui. Value of Intra-operative Ultrasound in Diagnosis of Tumor Residue after Resection of Intracranial Gliomas: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(5): 592-597. doi: 10.7507/1672-2531.20140098 Copy

1.	Sosna J, Barth MM, Kruskaal JB, et al. Intraoperative sonography for neurosurgery. J Ultrasound Med, 2005, 24(12):1671-1682.
2.	Erdogan N, Tucer B, Mavili E, et al. Ultrasound guidance in intracranial tumor resection:correlation with postoperative magnetic resonance findings. Acta Radiol, 2005, 46(7):743-749.
3.	Woydt M, Krone A, Becker G, et al. Correlation of intra-operative ultrasound with histopathologic findings after tumor resection in supratentorial gliomas. A method to improve gross total tumour resection. Acta Neurochir (Wien), 1996, 138(12):1391-1398.
4.	Unsgaard G, Selbekk T, Brostrup M T, et al. Ability of navigated 3D ultrasound to delineate gliomas and metastaseses-comparison of image interpretations with histopathology. Acta Neurochir(Wien), 2005, 147(12):1259-1269.
5.	贺焱, 何文, 杜丽娟, 等.术中超声造影对提高脑胶质瘤完全切除的临床应用价值.中华医学超声杂志:电子版, 2012, 9(1):36-39.
6.	王立淑, 何文, 刘会昭, 等.术中超声与病理评价颅脑胶质瘤切除程度的对照研究.中华医学超声杂志:电子版, 2009, 6(3):500-506.
7.	田永吉, 林松, 刘会昭, 等.术中超声判定脑胶质瘤边界的应用价值.中华医学杂志, 2009, 89(19):1305-1308.
8.	郭少琼, 陈远洪, 罗建彬.术中超声对脑胶质瘤术后残余肿瘤的观察研究.实用医学杂志, 2011, 27(5):852-854.
9.	陈运洪, 王向宇, 余力, 等.改进高分辨超声在脑胶质瘤术中应用技术.中华神经外科, 2006, 5(7):702-705.
10.	刘晶, 姚兰辉.术中超声对幕上胶质瘤术后残余的评价.乌鲁木齐:新疆医科大学, 2009.
11.	Becker G, Hofmann E, Woydt M, et al. Postoperative neuroimaging of high-grade gliomas:comparison of transcranial sonography, magnetic resonance imaging, and computed tomography. Neurosurgery, 1999, 44(3):469-477.
12.	Chacko AG, Kumar NK, Chacko G, et al. Intraoperative ultrasound in determining the extent of resection of parenchymal brain tumours-a comparative study with computed tomography and histopathology. Acta Neurochir(Wien), 2003, 145(9):743-748.
13.	Gerganov VM, Samii A, Giordano M, et al. Two-dimensional highend ultrasound imaging compared to intraoperative MRI during resection of low-grade gliomas. J Clin Neurosci, 2011, 18(5):669-673.
14.	Whiting P, Rutjes Aw, Reitsma JB, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25-38.
15.	黄强, 陈忠平, 兰青.胶质瘤.第1版.北京:中国科技出版社, 2000: 156-158.
16.	蒋传路, 江涛, 李永利, 等.胶质瘤的侵袭性生长与手术策略.中华神经外科杂志, 2004, 20(6):510.
17.	Enzmann DR, Wheat R, Marshall WH, et al. Tumors of the central nervous system studied by computed tomography and ultrasound. Radiology, 1985, 154(2):393-399.
18.	Hammoud MA, Ligon L, Mph RE, et al. Use of intra-operative ultrasound for localizing study with magnetic resonance imaging. J Neuresurg, 1996, 84(6):737-741.
19.	Matsushita Y, Okayama Y, Matsuo S. The role of intraoperative ultrasonography. Rinsho Byori, 2008, 56(6):498-507.
20.	欧亚梦兰, 李力, 高琨. TERC基因对宫颈高级别病变(≥CIN II)诊断价值的Meta分析.中国循证医学杂志, 2013, 13(3):325-331.

1. Sosna J, Barth MM, Kruskaal JB, et al. Intraoperative sonography for neurosurgery. J Ultrasound Med, 2005, 24(12):1671-1682.
2. Erdogan N, Tucer B, Mavili E, et al. Ultrasound guidance in intracranial tumor resection:correlation with postoperative magnetic resonance findings. Acta Radiol, 2005, 46(7):743-749.
3. Woydt M, Krone A, Becker G, et al. Correlation of intra-operative ultrasound with histopathologic findings after tumor resection in supratentorial gliomas. A method to improve gross total tumour resection. Acta Neurochir (Wien), 1996, 138(12):1391-1398.
4. Unsgaard G, Selbekk T, Brostrup M T, et al. Ability of navigated 3D ultrasound to delineate gliomas and metastaseses-comparison of image interpretations with histopathology. Acta Neurochir(Wien), 2005, 147(12):1259-1269.
5. 贺焱, 何文, 杜丽娟, 等.术中超声造影对提高脑胶质瘤完全切除的临床应用价值.中华医学超声杂志:电子版, 2012, 9(1):36-39.
6. 王立淑, 何文, 刘会昭, 等.术中超声与病理评价颅脑胶质瘤切除程度的对照研究.中华医学超声杂志:电子版, 2009, 6(3):500-506.
7. 田永吉, 林松, 刘会昭, 等.术中超声判定脑胶质瘤边界的应用价值.中华医学杂志, 2009, 89(19):1305-1308.
8. 郭少琼, 陈远洪, 罗建彬.术中超声对脑胶质瘤术后残余肿瘤的观察研究.实用医学杂志, 2011, 27(5):852-854.
9. 陈运洪, 王向宇, 余力, 等.改进高分辨超声在脑胶质瘤术中应用技术.中华神经外科, 2006, 5(7):702-705.
10. 刘晶, 姚兰辉.术中超声对幕上胶质瘤术后残余的评价.乌鲁木齐:新疆医科大学, 2009.
11. Becker G, Hofmann E, Woydt M, et al. Postoperative neuroimaging of high-grade gliomas:comparison of transcranial sonography, magnetic resonance imaging, and computed tomography. Neurosurgery, 1999, 44(3):469-477.
12. Chacko AG, Kumar NK, Chacko G, et al. Intraoperative ultrasound in determining the extent of resection of parenchymal brain tumours-a comparative study with computed tomography and histopathology. Acta Neurochir(Wien), 2003, 145(9):743-748.
13. Gerganov VM, Samii A, Giordano M, et al. Two-dimensional highend ultrasound imaging compared to intraoperative MRI during resection of low-grade gliomas. J Clin Neurosci, 2011, 18(5):669-673.
14. Whiting P, Rutjes Aw, Reitsma JB, et al. The development of QUADAS:a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25-38.
15. 黄强, 陈忠平, 兰青.胶质瘤.第1版.北京:中国科技出版社, 2000: 156-158.
16. 蒋传路, 江涛, 李永利, 等.胶质瘤的侵袭性生长与手术策略.中华神经外科杂志, 2004, 20(6):510.
17. Enzmann DR, Wheat R, Marshall WH, et al. Tumors of the central nervous system studied by computed tomography and ultrasound. Radiology, 1985, 154(2):393-399.
18. Hammoud MA, Ligon L, Mph RE, et al. Use of intra-operative ultrasound for localizing study with magnetic resonance imaging. J Neuresurg, 1996, 84(6):737-741.
19. Matsushita Y, Okayama Y, Matsuo S. The role of intraoperative ultrasonography. Rinsho Byori, 2008, 56(6):498-507.
20. 欧亚梦兰, 李力, 高琨. TERC基因对宫颈高级别病变(≥CIN II)诊断价值的Meta分析.中国循证医学杂志, 2013, 13(3):325-331.

Chinese Journal of Evidence-Based Medicine

Value of Intra-operative Ultrasound in Diagnosis of Tumor Residue after Resection of Intracranial Gliomas: A Meta-Analysis

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