Radiological predictors of shunt response in the diagnosis and treatment of idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis

Table 13 The use of cerebral atrophy for prediction of shunt response in iNPH

Study	Sample size	Radiological methodology	Cutoff specification	Image specification	Image plane	Main reported outcomes
McGirt et al. [34]	n = 132	•Not given	•N/A	•CT/MRI	•N/A	•30 (28%) of patients had diffuse cerebral atrophy, however it was not associated with a change in its outcome, univariate analysis showed a RR: 1.13 (95% CI: 0.69–1.83)
Hong et al. [20]	n = 3	•Hippocampal atrophy was measures suing Scheltens visual grading scale from 0–4. 4 being most atrophied	•N/A	•3.0 Tesla MRI scanner. T- Weighted image	•Coronal	•There was no significant difference between SR and SNR (p = 0.831). SR mean grade was 1.8 ± 0.9 while SNR was 1.9 ± 0.6. Univariate analysis showed an OR: 0.534 •(95% CI: 0.169–1.693) was insignificant at p = 0287

Studies included assessing the use of any advanced imaging radiological marker as predictor of shunt responsiveness. SR, shunt response; S-NR, shunt non-response; RR, risk ratio; OR, odds ratio; CI, confidence interval