220 Cochrane review of interval brain imaging in adults with cerebral glioma

Background

It is not known whether imaging at pre-specified time points after glioma diagnosis and treatment leads to better outcomes than triggered imaging performed in response to new or worsening symptoms.

Objectives

To systematically review the effect of different imaging strategies on health and economic outcomes for adults with cerebral glioma (grade 2 to 4).

Methods

CENTRAL, MEDLINE and Embase were searched up to 18/06/2019 for relevant RCTs and non- randomised studies comparing imaging strategies in adults with glioma. The NHS Economic Evaluation Database (EED) was also searched for relevant economic evaluations. We used standard Cochrane review methodology.

Findings

We included one retrospective study comparing early post-operative imaging (within 48 hours) with no early post-operative imaging among 125 adults with glioblastoma. Evidence suggested little or no difference in survival between approaches at one year (RR 0.86, 95% CI 0.61 to 1.21; 48% vs 55% died, respectively) and two years after diagnosis (RR 1.06, 95% CI 0.91 to 1.25; 86% vs 81% died, respectively) but was assessed as very low quality. No economic evaluations were found.

Conclusions

The effect of different imaging strategies on survival and other health outcomes remains largely unknown. Existing imaging schedules seem to be pragmatic rather than evidence-based.

robin.grant@luht.scot.nhs.uk