Low-field MR imaging of meningiomas including dynamic contrast enhancement study: evaluation of surgical and histopathologic characteristics
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Published on: July 5, 2021
S K Yrjänä1, H Tuominen, A Karttunen
1Department of Neurosurgery, Oulu University Hospital, Oulu, Finland. sanna.yrjana@oulu.fi
Background And Purpose:
Risks associated with surgery of meningiomas, especially those located in the skull base, are influenced by tumor consistency and vascularity. The purpose of this study was to find out if vascularity, consistency, and histologic characteristics of meningioma can be predicted preoperatively by using low-field MR imaging, including dynamic imaging of contrast enhancement.
Materials And Methods:
Twenty-one patients (mean age, 56; range, 34-73 years; 16 women, 5 men) with meningioma requiring first surgery were imaged by a 0.23T scanner. Time to maximum enhancement, maximum enhancement, and maximum intensity increase were noted from the enhancement curve of dynamic imaging. Relative intensity of tumor in fluid-attenuated inversion recovery (FLAIR) and T2-weighted images was calculated. The neurosurgeon evaluated surgical bleeding and hardness of tumor on a visual analog scale. Histopathologic analysis included subtype, World Health Organization grade, mitotic activity, grades of progesterone receptor expression and collagen content, proliferation activity by Ki-67 (MIB-1), and microvessel density by CD34. Correlations were studied with Kendall tau statistics.
Results:
The most powerful association was found between time to maximum enhancement and microvessel density (tau = -0.60, P < .001). Surgical bleeding (tau = 0.49, P = .002), blood loss during surgery (tau = 0.49, P = .002), progesterone receptor expression (tau = 0.59, P < .001), and collagen content (tau = -0.54, P < .001) were statistically best correlated with the relative intensity of meningioma on FLAIR images. Tissue hardness correlated best with relative intensity on T2-weighted images (tau = 0.40, P = .012).
Conclusion:
Assessment of microvessel density, collagen content, and progesterone receptor expression of meningioma may be clinically feasible by using low-field MR imaging.
Insights
Low-field MRI can predict meningioma characteristics like vascularity and collagen content. This imaging technique may help assess tumor features preoperatively, aiding surgical planning for meningioma patients.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Meningioma surgery risks are linked to tumor consistency and vascularity.
- Skull base meningiomas present unique surgical challenges.
Purpose of the Study:
- To determine if low-field MRI can preoperatively predict meningioma vascularity, consistency, and histologic features.
- To evaluate dynamic contrast enhancement imaging for predicting tumor characteristics.
Main Methods:
- Twenty-one meningioma patients underwent 0.23T MRI, including dynamic contrast enhancement.
- MR imaging parameters (intensity, enhancement curves) were correlated with surgical findings and histopathology (subtype, grade, receptor expression, collagen, MIB-1, microvessel density).
Main Results:
- Time to maximum enhancement strongly correlated with microvessel density (tau = -0.60).
- FLAIR image intensity correlated with surgical bleeding, blood loss, progesterone receptor expression, and collagen content.
- T2-weighted image intensity correlated with tissue hardness.
Conclusions:
- Low-field MRI shows promise for non-invasively assessing meningioma microvessel density, collagen content, and progesterone receptor expression.
- Preoperative prediction of these histologic features may be clinically feasible using low-field MR imaging.
