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Published on: December 16, 2021
Perfusion MR imaging for differentiation of benign and malignant meningiomas
Hao Zhang1, Lars A Rödiger, Tianzhen Shen
1Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. zhanghao021@hotmail.com
Introduction:
Our purpose was to determine whether perfusion MR imaging can be used to differentiate benign and malignant meningiomas on the basis of the differences in perfusion of tumor parenchyma and/or peritumoral edema.
Methods:
A total of 33 patients with preoperative meningiomas (25 benign and 8 malignant) underwent conventional and dynamic susceptibility contrast perfusion MR imaging. Maximal relative cerebral blood volume (rCBV) and the corresponding relative mean time to enhance (rMTE) (relative to the contralateral normal white matter) in both tumor parenchyma and peritumoral edema were measured. The independent samples t-test was used to determine whether there was a statistically significant difference in the mean rCBV and rMTE ratios between benign and malignant meningiomas.
Results:
The mean maximal rCBV values of benign and malignant meningiomas were 7.16+/-4.08 (mean+/-SD) and 5.89+/-3.86, respectively, in the parenchyma, and 1.05+/-0.96 and 3.82+/-1.39, respectively, in the peritumoral edema. The mean rMTE values were 1.16+/-0.24 and 1.30+/-0.32, respectively, in the parenchyma, and 0.91+/-0.25 and 1.24+/-0.35, respectively, in the peritumoral edema. The differences in rCBV and rMTE values between benign and malignant meningiomas were not statistically significant (P>0.05) in the parenchyma, but both were statistically significant (P<0.05) in the peritumoral edema.
Conclusion:
Perfusion MR imaging can provide useful information on meningioma vascularity which is not available from conventional MRI. Measurement of maximal rCBV and corresponding rMTE values in the peritumoral edema is useful in the preoperative differentiation between benign and malignant meningiomas.
Insights
Perfusion MRI can help distinguish benign from malignant meningiomas by analyzing tumor and surrounding edema. Measurements in the peritumoral edema showed significant differences, aiding preoperative diagnosis.
Area of Science:
- Neuroradiology
- Medical Imaging
- Oncology
Background:
- Meningiomas are common primary tumors of the central nervous system.
- Differentiating benign from malignant meningiomas preoperatively is crucial for treatment planning.
- Conventional MRI may not always provide sufficient information for accurate differentiation.
Purpose of the Study:
- To evaluate the efficacy of perfusion MR imaging in differentiating benign and malignant meningiomas.
- To assess differences in tumor parenchyma and peritumoral edema perfusion between benign and malignant meningiomas.
Main Methods:
- 33 patients with meningiomas underwent dynamic susceptibility contrast perfusion MR imaging.
- Maximal relative cerebral blood volume (rCBV) and relative mean time to enhance (rMTE) were measured in tumor parenchyma and peritumoral edema.
- Independent samples t-test was used to compare rCBV and rMTE values between benign and malignant groups.
Main Results:
- No statistically significant differences in rCBV and rMTE were found in the tumor parenchyma.
- Statistically significant differences in rCBV and rMTE were observed in the peritumoral edema (P<0.05).
- Malignant meningiomas showed higher rCBV and rMTE values in the peritumoral edema compared to benign.
Conclusions:
- Perfusion MR imaging offers valuable insights into meningioma vascularity beyond conventional MRI.
- Measuring rCBV and rMTE in the peritumoral edema is a useful method for preoperative differentiation of meningiomas.
- This technique can aid in surgical planning and patient management.
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