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Is diffusion-weighted imaging useful in grading and differentiating histopathological subtypes of meningiomas?
S Eser Sanverdi1, Burce Ozgen, Kader K Oguz
1Hacettepe University, Faculty of Medicine, Department of Radiology, Turkey. esersanverdi@yahoo.com
Purpose:
Meningiomas are mostly benign, however atypical or malignant subtypes with more aggressive clinical course and higher recurrence rates can also be seen. The purpose of this study was to determine whether histopathological subtypes of meningiomas could be assessed preoperatively using apparent diffusion coefficient (ADC) values.
Materials And Methods:
Conventional magnetic resonance (MR) and diffusion-weighted (DW) imaging of 177 adult patients with pathologically proven meningiomas were retrospectively evaluated. Tumor size and the degree of associated edema were noted. The signal intensity of the lesions on DW imaging was evaluated and graded. Mean ADC values were obtained as the mean of measurements from three regions of interests within the mass. ADC ratios of meningioma/contralateral normal appearing subcortical parietal white matter were also calculated.
Results:
The histopathological analysis revealed 135 benign, 37 atypical and 5 malignant lesions. With classification according to the subtype, the mean ADC values and ratios of benign meningiomas were as 0.99±0.12×10(-3) mm(2)/s and 1.22±0.07, respectively. ADC values for atypical and malignant groups were both 0.84±0.1×10(-3) mm(2)/s. The ADC ratios were 1.05±0.1 and 0.96±0.2 for atypical and malignant subtypes, respectively. There was no statistically significant difference between the mean ADC ratios of the three subtypes (ANOVA test; P≥0.05). Gender, age of the patients and tumor size showed no statistically significant difference between the different histological groups.
Conclusion:
DW MR imaging was not found to have any additional value in determining histological behaviour nor in differentiating histopathological subtypes of meningiomas.
Insights
Apparent diffusion coefficient (ADC) values from diffusion-weighted MRI did not help differentiate meningioma subtypes. This study found no significant differences in ADC values between benign, atypical, and malignant meningiomas.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Meningiomas are typically benign brain tumors.
- Atypical and malignant subtypes exhibit more aggressive behavior and higher recurrence rates.
- Preoperative differentiation of meningioma subtypes is clinically important.
Purpose of the Study:
- To investigate if apparent diffusion coefficient (ADC) values obtained from diffusion-weighted magnetic resonance (DW MR) imaging can preoperatively assess histopathological subtypes of meningiomas.
- To determine the utility of ADC values in differentiating benign, atypical, and malignant meningiomas.
Main Methods:
- Retrospective analysis of DW MR imaging in 177 adult patients with pathologically confirmed meningiomas.
- Calculation of mean ADC values and ADC ratios (lesion/contralateral white matter).
- Evaluation of tumor size and associated edema.
Main Results:
- Histopathological analysis identified 135 benign, 37 atypical, and 5 malignant meningiomas.
- Mean ADC values and ratios showed no statistically significant differences between benign, atypical, and malignant subtypes.
- Patient demographics and tumor size did not correlate with histological subtypes.
Conclusions:
- Diffusion-weighted MR imaging, using ADC values, does not provide additional value in determining the histological behavior or differentiating subtypes of meningiomas.
- Current DW MR imaging techniques are insufficient for preoperative grading of meningiomas based on ADC values.
