TY - JOUR
T1 - Apparent Diffusion Coefficient Values and Dynamic Contrast-Enhanced Magnetic Resonance Perfusion are Potential Predictors for Grading Meningiomas
AU - Utomo, Sri Andreani
AU - Bajamal, Abdul Hafid
AU - Yueniwati, Yuyun
AU - Sanjaya, Irfan Deny
AU - Fauziah, Dyah
N1 - Publisher Copyright:
© 2022, The author(s).
PY - 2022
Y1 - 2022
N2 - Purpose: Distinguishing between high-grade and low-grade meningiomas might be difficult but has high clinical value in deciding precise treatment and prognostic factors. Magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) values and dynamic contrast enhancement (DCE) may have a significant role in capturing such complexities. Methods: Data from our hospital database on meningioma patients from January 2020 to December 2021 were obtained. The MRI results of all patients were evaluated for mean ADC value and DCE parameters, including time-signal intensity curves (TIC), maximum signal intensity (SImax), time to maximum signal intensity (Tmax), maximum contrast enhancement ratio (MCER), and slope. Results: In this retrospective analysis, 33 individuals were included. Twenty-eight (84.8%) patients were pathologically diagnosed with low-grade meningioma and five (15.2%) patients with high-grade meningioma. There is a crossover between high-and low-grade meningiomas in conventional MRI. Tumor size, location, shape, necrotic/cystic changes, peritumoral edema, and enhancement patterns did not differ substantially between groups (p = 0.39, 0.23, 0.28, 0.57, 0.56, and 0.33, respectively). The mean ADC and Tmax values of high-grade meningiomas were substantially lower than those of low-grade meningiomas (p = 0.002 and 0.02, respectively). An optimal cut-off of 0.87 × 10−3 mm2s−1 for the mean ADC value (area under the curve [AUC] = 0.94, sensitivity = 80%, specificity = 92.8%) and 42 s for Tmax (AUC = 0.84, sensitivity = 80%, specificity = 89.3%) was suggested. High-grade meningiomas had significantly higher TIC, SImax, MCER, and slope than low-grade meningiomas (p = 0.004, < 0.001, 0.01, and 0.001, respectively). Type IV TIC had a sensitivity of 80% and specificity of 89.3% in distinguishing high-grade meningiomas from low-grade meningiomas. Optimal cut-offs of 940.2 for SImax (AUC = 0.98, sensitivity = 80%, specificity = 96.4%), 245% for MCER (AUC = 0.94, sensitivity = 80%, specificity = 85.7%), and 5% per second for slope (AUC = 0.97, sensitivity = 80%, specificity = 96.4%) were estimated. Conclusion: The ADC value and DCE-MRI parameters (TIC, SImax, Tmax, MCER, and slope) are potential predictors for separating high-grade from low-grade meningiomas.
AB - Purpose: Distinguishing between high-grade and low-grade meningiomas might be difficult but has high clinical value in deciding precise treatment and prognostic factors. Magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) values and dynamic contrast enhancement (DCE) may have a significant role in capturing such complexities. Methods: Data from our hospital database on meningioma patients from January 2020 to December 2021 were obtained. The MRI results of all patients were evaluated for mean ADC value and DCE parameters, including time-signal intensity curves (TIC), maximum signal intensity (SImax), time to maximum signal intensity (Tmax), maximum contrast enhancement ratio (MCER), and slope. Results: In this retrospective analysis, 33 individuals were included. Twenty-eight (84.8%) patients were pathologically diagnosed with low-grade meningioma and five (15.2%) patients with high-grade meningioma. There is a crossover between high-and low-grade meningiomas in conventional MRI. Tumor size, location, shape, necrotic/cystic changes, peritumoral edema, and enhancement patterns did not differ substantially between groups (p = 0.39, 0.23, 0.28, 0.57, 0.56, and 0.33, respectively). The mean ADC and Tmax values of high-grade meningiomas were substantially lower than those of low-grade meningiomas (p = 0.002 and 0.02, respectively). An optimal cut-off of 0.87 × 10−3 mm2s−1 for the mean ADC value (area under the curve [AUC] = 0.94, sensitivity = 80%, specificity = 92.8%) and 42 s for Tmax (AUC = 0.84, sensitivity = 80%, specificity = 89.3%) was suggested. High-grade meningiomas had significantly higher TIC, SImax, MCER, and slope than low-grade meningiomas (p = 0.004, < 0.001, 0.01, and 0.001, respectively). Type IV TIC had a sensitivity of 80% and specificity of 89.3% in distinguishing high-grade meningiomas from low-grade meningiomas. Optimal cut-offs of 940.2 for SImax (AUC = 0.98, sensitivity = 80%, specificity = 96.4%), 245% for MCER (AUC = 0.94, sensitivity = 80%, specificity = 85.7%), and 5% per second for slope (AUC = 0.97, sensitivity = 80%, specificity = 96.4%) were estimated. Conclusion: The ADC value and DCE-MRI parameters (TIC, SImax, Tmax, MCER, and slope) are potential predictors for separating high-grade from low-grade meningiomas.
KW - ADC value
KW - DCE-MRI
KW - Grading meningioma
UR - http://www.scopus.com/inward/record.url?scp=85135889642&partnerID=8YFLogxK
U2 - 10.7150/ijms.75092
DO - 10.7150/ijms.75092
M3 - Article
AN - SCOPUS:85135889642
SN - 1449-1907
VL - 19
SP - 1364
EP - 1376
JO - International Journal of Medical Sciences
JF - International Journal of Medical Sciences
IS - 9
ER -