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Updated: Jun 13, 2026
Diffusion Imaging in the Rat Cervical Spinal Cord
Published on: April 7, 2015
Diffusion-weighted imaging does not predict histological grading in meningiomas
Luca Santelli1, Gaetano Ramondo, Alessandro Della Puppa
1Department of Neuroradiology, Azienda Ospedaliera Università di Padova, Padova, Italy.
Purpose:
This study aims to verify the reliability of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurements to differentiate benign from atypical/malignant meningiomas and among different sub-types.
Methods:
Pre-operative DWI of 102 patients (74 females, mean age 58 years, age range 34-85 years) affected by a pathologically proven intracranial meningioma were retrospectively reviewed. DWI signal intensity of tumors was classified as hypo-, iso- or hyper-intense to grey matter. ADC values and normalised ADC(ratio) (ADC(meningioma)/ADC(normal appearing white matter)) of the neoplastic tissue (avoiding calcifications and cystic or necrotic areas) were measured by two neuroradiologists unaware of each others' reading. MRI and histological findings were compared.
Results:
Meningiomas were histologically graded as malignant (1%), atypical (21.5%) and benign (77.5%). Meningothelial, transitional and fibrous were the most frequent benign sub-types (44, 16 and 10 cases, respectively). There was no statistical difference between typical and atypical/malignant meningiomas when considering mean ADC values (0.964 +/- 0.192 x 10(-3) vs 0.923 +/- 0.085 x 10(-3) cm(2)/s, p = 0.3 t-Student) or ADC(ratio) (1.266 +/- 0.290 vs 1.185 +/- 0.115, p = 0.2 t-Student). ADC values or ADC(ratio) did not differ significantly among meningioma sub-types although a nearly significant difference was found between meningothelial and transitional (post hoc analysis p = 0.06). Inter-observer agreement of ADC and ADC(ratio) measurements was high (r = 0.95 and 0.92, respectively, Pearson's linear coefficient). DWI intensity did not reach a significant correlation with meningioma's grading (p = 0.08).
Conclusions:
According to our study, DWI and ADC measurement do not seem reliable in grading meningiomas or identifying histological sub-types. Hence, these parameters should not be recommended for surgical or treatment planning.
Insights
Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurements are not reliable for grading meningiomas or identifying subtypes. These parameters are not recommended for surgical or treatment planning.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Meningiomas are the most common primary intracranial tumors.
- Accurate grading and subtyping are crucial for treatment planning.
- Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurements are non-invasive techniques that may aid in tumor characterization.
Purpose of the Study:
- To evaluate the reliability of DWI and ADC measurements in differentiating benign from atypical/malignant meningiomas.
- To assess the utility of DWI and ADC in distinguishing between different histological subtypes of meningiomas.
Main Methods:
- Retrospective review of pre-operative DWI from 102 patients with pathologically proven intracranial meningiomas.
- Classification of tumor DWI signal intensity relative to grey matter.
- Measurement of ADC values and normalized ADC ratios by two independent neuroradiologists.
- Comparison of imaging findings with histological grading and subtyping.
Main Results:
- No statistically significant difference in mean ADC values or ADC ratios between typical and atypical/malignant meningiomas.
- ADC values and ADC ratios did not significantly differ among meningioma subtypes.
- High inter-observer agreement for ADC and ADC ratio measurements (r = 0.95 and 0.92).
- DWI signal intensity did not significantly correlate with meningioma grading.
Conclusions:
- DWI and ADC measurements appear unreliable for grading meningiomas or identifying histological subtypes.
- These imaging parameters are not recommended for surgical or treatment planning in meningioma cases.
- Further research may be needed to explore other advanced imaging techniques for meningioma characterization.
