@article{6701a036e4eb42348c102394882fd979,
title = "Accuracy of presurgical functional MR imaging for language mapping of brain tumors: A systematic review and meta-analysis",
abstract = "Purpose: To compare functional magnetic resonance (MR) imaging for language mapping (hereafter, language functional MR imaging) with direct cortical stimulation (DCS) in patients with brain tumors and to assess factors associated with its accuracy. Materials and Methods: PubMed/MEDLINE and related databases were searched for research articles published between January 2000 and September 2016. Findings were pooled by using bivariate random-effects and hierarchic summary receiver operating characteristic curve models. Meta-regression and subgroup analyses were performed to evaluate whether publication year, functional MR imaging paradigm, magnetic field strength, statistical threshold, and analysis software affected classification accuracy. Results: Ten articles with a total of 214 patients were included in the analysis. On a per-patient basis, the pooled sensitivity and specificity of functional MR imaging was 44% (95% confidence interval [CI]: 14%, 78%) and 80% (95% CI: 54%, 93%), respectively. On a per-tag basis (ie, each DCS stimulation site or {"}tag{"} was considered a separate data point across all patients), the pooled sensitivity and specificity were 67% (95% CI: 51%, 80%) and 55% (95% CI: 25%, 82%), respectively. The per-tag analysis showed significantly higher sensitivity for studies with shorter functional MR imaging session times (P = .03) and relaxed statistical threshold (P = .05). Significantly higher specificity was found when expressive language task (P = .02), longer functional MR imaging session times (P , .01), visual presentation of stimuli (P = .04), and stringent statistical threshold (P = .01) were used. Conclusion: Results of this study showed moderate accuracy of language functional MR imaging when compared with intraoperative DCS, and the included studies displayed significant methodologic heterogeneity.",
author = "Weng, {Hsu Huei} and Noll, {Kyle R.} and Johnson, {Jason M.} and Prabhu, {Sujit S.} and Tsai, {Yuan Hsiung} and Chang, {Sheng Wei} and Huang, {Yen Chu} and Lee, {Jiann Der} and Yang, {Jen Tsung} and Yang, {Cheng Ta} and Tsai, {Ying Huang} and Yang, {Chun Yuh} and Hazle, {John D.} and Schomer, {Donald F.} and Liu, {Ho Ling}",
note = "Funding Information: 1From the Departments of Diagnostic Radiology (H.H.W., Yuan-Hsiung Tsai, S.W.C.), Neurology (Y.C.H., J.D.L.), and Neurosurgery (J.T.Y.), Chang Gung Memorial Hospital, Chiayi, Chang Gung University College of Medicine, Taiwan; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan (H.H.W.); Department of Psychology, National Chung Cheng University, Chiayi, Taiwan (H.H.W.); Department of Imaging Physics (H.H.W., J.D.H., H.L.L.), Department of Diagnostic Radiology (J.M.J., D.F.S.), Division of Diagnostic Imaging, Department of Neuro-Oncology, Section of Neuropsychology, Division of Cancer Medicine (K.R.N.), Department of Neurosurgery, Division of Surgery (S.S.P.), The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030; Division of Pulmonary and Critical Care Medicine of Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.T.Y.); Department of Respiratory Care, College of Medicine (C.T.Y.), Department of Respiratory Therapy (Ying-Huang Tsai), Chang Gung University, Taoyuan, Taiwan; Division of Pulmonary and Critical Care Medicine and Department of Respiratory Care, Chang Gung Memorial Hospital, Chiayi, Taiwan (Ying-Huang Tsai); and Faculty of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (C.Y.Y.). Received December 29, 2016; revision requested March 6, 2017; revision received July 11; accepted July 31; final version accepted July 31. Address correspondence to H.L.L. (e-mail: HLALiu@mdanderson.org).",
year = "2018",
month = feb,
doi = "10.1148/radiol.2017162971",
language = "English (US)",
volume = "286",
pages = "512--523",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",
}