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Published on: July 5, 2021
[The role of diffusion-weighted imaging in the evaluation of meningiomas: radio-pathologic correlation]
T Cabada1, M C Caballero, I Insausti
1Servicio de Radiología, Hospital de Navarra, Pamplona, Spain. tcabadag@cfnavarra.es
Objective:
To study the behavior of meningiomas in diffusion-weighted sequences and the correlation of these findings with the histological findings.
Material And Methods:
We prospectively included all patients operated on for meningiomas at our hospital during two years. We studied 30 meningiomas in 28 patients aged 31 to 85 years old. All patients underwent MRI prior to surgery, including diffusion-weighted sequences, in a 1.5 T scanner. We evaluated the signal intensity in T2-weighted images, diffusion-weighted images (b=1,000), and apparent diffusion coefficient (ADC) maps within the tumor and in the parietal white matter as a reference. In the histological study, cellularity, proliferation index, histological grade, and cerebral invasion were evaluated.
Results:
Of the 30 meningiomas, 22 were World Health Organization (WHO) grade I and 8 were atypical or WHO grade II. The overall mean value of the ADC was 89.19+/-13.95x10(-3) mm2/s; the mean ADC value was 82+/-13.69x10(-3) mm2/s in the atypical group and 92.21+/-13.21x10(-3) mm2/s in the typical group. No statistically significant differences were found between the 2 groups. Two subtypes of typical meningiomas, secretory and angiomatous meningiomas, had the highest values in the ADC maps. In the histological analysis, there was a significant association between tumor cellularity and the signal in the ADC map.
Conclusion:
Meningiomas show moderately restricted diffusion. The signal on the ADC map is associated with tumor cellularity but we have not demonstrated its usefulness for predicting the histological grade.
Insights
Meningiomas exhibit moderately restricted diffusion on MRI. Apparent Diffusion Coefficient (ADC) signal correlates with tumor cellularity but does not predict histological grade.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Meningiomas are common primary brain tumors.
- Diffusion-weighted imaging (DWI) provides insights into tissue microstructure.
- Understanding meningioma behavior on DWI aids in diagnosis and characterization.
Purpose of the Study:
- To investigate meningioma behavior using diffusion-weighted MRI sequences.
- To correlate MRI findings with histological characteristics of meningiomas.
Main Methods:
- Prospective study of 30 meningiomas in 28 patients using 1.5 T MRI with DWI.
- Analysis of signal intensity on T2-weighted images, DWI (b=1,000), and apparent diffusion coefficient (ADC) maps.
- Histological evaluation included cellularity, proliferation index, grade, and invasion.
Main Results:
- No significant difference in mean ADC values between typical (WHO grade I) and atypical (WHO grade II) meningiomas.
- Secretory and angiomatous meningiomas showed higher ADC values.
- Tumor cellularity was significantly associated with the signal intensity on ADC maps.
Conclusions:
- Meningiomas demonstrate moderately restricted diffusion.
- ADC map signal is linked to tumor cellularity.
- DWI is not definitively useful for predicting meningioma histological grade.
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