Diagnostic performance of the medial temporal lobe atrophy scale in patients with Alzheimer’s disease: a systematic review and meta-analysis

Objective To evaluate the diagnostic performance and reliability of the medial temporal lobe atrophy (MTA) scale in patients with Alzheimer’s disease. Methods A systematic literature search of MEDLINE and EMBASE databases was performed to select studies that evaluated the diagnostic performance or reliability of MTA scale, published up to January 21, 2021. Pooled estimates of sensitivity and specificity were calculated using a bivariate random-effects model. Pooled correlation coefficients for intra- and interobserver agreements were calculated using the random-effects model based on Fisher’s Z transformation of correlations. Meta-regression was performed to explain the study heterogeneity. Subgroup analysis was performed to compare the diagnostic performance of the MTA scale and hippocampal volumetry. Results Twenty-one original articles were included. The pooled sensitivity and specificity of the MTA scale in differentiating Alzheimer’s disease from healthy control were 74% (95% CI, 68–79%) and 88% (95% CI, 83–91%), respectively. The area under the curve of the MTA scale was 0.88 (95% CI, 0.84–0.90). Meta-regression demonstrated that the difference in the method of rating the MTA scale was significantly associated with study heterogeneity ( p = 0.04). No significant difference was observed in five studies regarding the diagnostic performance between MTA scale and hippocampal volumetry ( p = 0.40). The pooled correlation coefficients for intra- and interobserver agreements were 0.85 (95% CI, 0.69–0.93) and 0.83 (95% CI, 0.66–0.92), respectively. Conclusions Our meta-analysis demonstrated a good diagnostic performance and reliability of the MTA scale in Alzheimer’s disease. Key Points • The pooled sensitivity and specificity of the MTA scale in differentiating Alzheimer’s disease from healthy control were 74% and 88%, respectively. • There was no significant difference in the diagnostic performance between MTA scale and hippocampal volumetry. • The reliability of MTA scale was excellent based on the pooled correlation coefficient for intra- and interobserver agreements.