The role of DTI in surgical management of brainstem cavernous malformations: A meta-analysis of 4159 cases
Abstract
BACKGROUND: Brainstem cavernous malformations (BSCMs) are challenging neurosurgical entities due to their critical location. Advanced imaging techniques like diffusion tensor imaging (DTI) have emerged as potential tools for improving surgical outcomes.
PURPOSE: To compare the efficacy and outcomes of diffusion tensor imaging (DTI) versus conventional magnetic resonance imaging (MRI) or computed tomography (CT) in the surgical management of brainstem cavernous malformations (BSCM).
DATA SOURCES: A systematic review of studies published from 2007 to 2023 was conducted using data from Pubmed, Embase, and Scopus.
STUDY SELECTION: 106 studies involving 4159 patients with BSCM were included. Patients were stratified into two cohorts: those who received DTI/DTT (n = 382) and those who received only MRI/CT (n = 3777).
DATA ANALYSIS: Primary outcomes included gross total resection rates, clinical improvement, stability, and worsening, as well as complications. Meta-analysis was performed using a random-effects model. Multivariate regression analysis was conducted to identify factors impacting outcomes in the DTI/DTT cohort.
DATA SYNTHESIS: The DTI/DTT cohort demonstrated a significantly higher gross total resection rate compared to the MRI/CT cohort (94.9 % vs. 87.0 %, p = 0.025). Clinical improvement was observed in 71.5 % of the DTI/DTT group versus 65.6 % in the MRI/CT group (p = 0.343). The DTI/DTT group showed a significantly lower rate of clinical worsening (5.1 % vs. 11.4 %,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 4,159 participants or records.
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