Effect of using Diffusion-Weightage Imaging on Diagnostic Accuracy of MRI in catching Parotid carcinoma: A meta-analysis

BackgroundA wide variety of benign and malignant tumors can develop in the salivary gland, which makes up roughly 3-5% of all head and neck tumors. Making a precise pre-operative distinction between benign and malignant salivary gland tumors, or identifying the precise histologic subtype, is crucial since this knowledge has a significant impact on the treatment strategy. The results of fine-needle aspiration cytology can occasionally be inaccurate since it is an intrusive procedure for diagnosing parotid tumors before surgery. Because of the tiny sample size or the deep placement of the tumor, it is sometimes impossible to gather adequate samples therefore Salivary gland tumors are increasingly being evaluated before surgery using MRI since it can pinpoint their precise location, size, and surrounding tissues. MethodsMedical literature was comprehensively searched and reviewed without restrictions to particular study designs, or publication dates using PubMed, Cochrane Library, and Google Scholar databases for all relevant literature. The extraction of necessary data proceeded after specific inclusion and exclusion criteria were applied. The inclusion criteria were as follows:; (1) Literature that provided information about the accurate diagnosis with MRI(DWI) and only MRI ; (2) papers published in English; (3) papers with appropriate patient criteria. The exclusion criteria were: (1) articles that were not full text, (2) unpublished articles, and (3) non-English articles. In this Meta-Analysis, a total of 8 RCTs with a total of 944 patients were selected, out of which 3 RCTs with a total of 356 patients were selected for MRI and 5 RCTs with a total of 588 patients were selected for MRI+DWI study. wherein two writers independently assessed the caliber of each study as well as the use of the Cochrane tool for bias risk apprehension. The statistical software packages RevMan (Review Manager, version 5.3), SPSS (Statistical Package for the Social Sciences, version 20), and Excel in Stata 14 were used to perform the statistical analyses. ResultsWe calculated the sensitivity and specificity of MRI in diagnosing parotid gland lesions in the different papers, For the MRI, The sensitivity is 0.81 with a CI of 95% in a range of 0.77 to 0.86, the mean being 0.049. The Sensitivity of the MRI is 0.790 with a CI of 95% in a range of (0.772 to 0.809) the mean being (0.0183). The Specificity of the MRI is 0.794 with a CI of 95% in a range of (0.613 to 0.975) the mean being (0.181). For the MRI+DWI study, The Sensitivity of the MRI+DWI is 0.618 with a CI of 95% in a range of (0.498 to 0.737); the mean being (0.119). The Specificity of the MRI+DWI is 0.892 with a CI of 95% in a range of (0.813 to 0.97) the mean being (0.079). ConclusionIn addition to simple MRI or Single DWI MRI, A combination of both would detect higher lesions and it should be helpful for staging and early diagnosis purposes only.