Quantitative Consistency of Amide Proton Transfer-Weighted MRI for Brain Tumor Differentiation: Systematic Review of Clinical Evidence
Abstract
Background/objectives: Accurate grading of brain gliomas is important, and amide proton transfer-weighted (APTw) MRI shows promise for non-invasive tumor differentiation. This study aimed to perform a comprehensive review and meta-analyses to demonstrate heterogeneity in both the diagnostic accuracy and quantitative consistency of APTw MRI in distinguishing high-grade gliomas (HGGs) from low-grade gliomas (LGGs), highlight issues with reporting standards and identify sources of heterogeneity through meta-regression.
Methods: A systematic literature search was conducted between 1 January 2013 and 18 January 2026, following PRISMA guidelines. Peer-reviewed articles in English reporting diagnostic accuracy/contrast values of APTw MRI and study parameters were included. Principal component analysis (PCA) was used to extract the principal components (PCs) of the chemical exchange saturation transfer (CEST) contrast mechanism. Random-effects meta-analyses and univariate meta-regression models using individual CEST parameters and three PCs were performed. Forest plots with pooled estimates were generated. Leave-one-out meta-analysis (LOOMA) and complete case analysis were performed to examine the effects of outliers and missing data, respectively.
Results: A total of 31 studies were included. Meta-analyses of the AUC and mean difference demonstrated significant heterogeneity across the studies (I2 = 73.9% & 78.2%, p p = 0.034) and the total PC (p = 0.02). The heterogeneity for the…
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.
Read the paper
Related studies
- Learning from First-Generation Qualitative Approaches in the IS Discipline: An Evolutionary View and Some Implications for Authors and Evaluators (PART 1/2)
- Commentary on the clinical and preclinical dosage limits of interstitially administered magnetic fluids for therapeutic hyperthermia based on current practice and efficacy models
- Prosthesis: New Technological Opportunities and Innovative Biomedical Devices
- The history and future of neural modeling for cochlear implants
- Ryanodine receptors: waking up from refractoriness
- Novel Transgenic Rabbit Model Sheds Light on the Puzzling Role of Matrix Metalloproteinase-12 in Atherosclerosis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.