Authors' results and conclusions: 15 studies were retrieved that compared the results from pMRi with those of the histology (reference test). The main threats to the internal validity dealt with little sample size of most of the studies, ignorance of the time elapsed between testing and another one for most of the studies, ignorance concerning the pathologists’ and radiologists’ experience, and lack of knowledge on how the results that were difficult to assess were handled. No important threats were found concerning the external validity. The results of the estimated parameters were the following:_ Sensitivity: 0.958._ Specificity: 0.806._ Positive probability ratio: 3.923._ Negative probability ratio: 0.086.The results did not change after the sensitivity analysis. The cost-effectiveness analysis of the strategies, taking life years as effectiveness, got: on the one hand, the average cost per patient –which is 147.36 higher in pMRi than in the other one- and the effectiveness measured in life years, which is equally higher in this strategy (0.19 years). On the other hand, the incremental cost-effectiveness ratio (ICER) of pMRi as compared with biopsy is 788.22 per life years.

Authors' recommendations: _PMRI can get good results in differentiating the grade of malignancy of brain gliomas._ More and better research are required to be able to determine, from the scientific evidence, the role that pMRi must carry out in differentiating the grade of malignancy of brain gliomas._ From the incidence estimated for the Spanish population, which was 3.5 per 100,000 people, and the sensitivity and specificity parameters of the test, the use of pMRi would mean to diagnose 51 patients with a grade lower than what they really have. However, the use of Bx would convey 14 cases of complications and 20 cases of death more._ On the other hand, the average cost per patient of pMRi was 147.36 more than in Bx, albeit the effectiveness measured in life years is also higher in pMRi (0.19 years).The cost effectiveness analysis gave 776 as a result of cost per life year ratio (ICER) for pMRi when compared to Biopsy. Likewise, the results are sensitive due to probability to die caused by biopsy. The reason lies in the fact that when the biopsy is lower than 0,005, the pRM passes to be a dominated alternative._ The use pMRi would entail an additional annual cost of approximately 444,000._ While no better scientific evidence is obtained, pMRi can work complementarily as additional test in the cases in which the diagnostic tests previously performed have not clarified the doubt on the grade of malignancy of a glioma.

Project Status: Completed

URL for project: https://www.aetsa.org/publicacion/resonancia-magnetica-perfusion-en-la-diferenciacion-de-los-gliomas-cerebrales-metanalisis-y-evaluacion-economica/

Year Published: 2008

URL for published report: https://www.aetsa.org/download/publicaciones/antiguas/AETSA_2006-12_RMPerfusion.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: Andalusian Agency for Health Technology Assessment (AETSA)