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Prediction of hard meningiomas: quantitative evaluation based on the magnetic resonance signal intensity
Keita Watanabe1, Shingo Kakeda2, Junkoh Yamamoto3
1Department of Radiology, University of Occupational and Environmental Health School of Medicine, Japan sapient@med.uoeh-u.ac.jp.
Background:
From a surgical perspective, presurgical prediction of meningioma consistency is beneficial.
Purpose:
To quantitatively analyze the correlation between the magnetic resonance (MR) signal intensity (SI) or apparent diffusion coefficient (ADC) and meningioma consistency and to determine which MR sequence could help predicting hard meningiomas.
Material And Methods:
This study included 43 patients with meningiomas who underwent preoperative MR imaging (MRI), including T1-weighted (T1W) imaging, T2-weighted (T2W) imaging, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI), contrast-enhanced (CE)-T1W imaging, and CE-fast imaging employing steady-state acquisition (FIESTA). A neurosurgeon evaluated the tumor consistency using a visual analog scale (VAS) with the anchors "soft" (score = 0) and "hard" (score = 10). The SI ratio (tumor to cerebral cortex SI) and ADC value were compared with the tumor consistency. The sensitivity, specificity, and accuracy for predicting hard meningiomas (VAS score ≥8; 9 of 43 patients) were calculated using cutoff values for the SI ratio that were obtained in a receiver operating characteristic curve analysis.
Results:
A significant negative correlation was observed between the tumor consistency and the SI ratio on T2W imaging, FLAIR, and CE-FIESTA (P < 0.05) but not on T1W imaging, CE-T1W imaging, and the ADC value. The sensitivity, specificity, and accuracy for predicting hard meningiomas were 89%, 79%, and 81% with T2W imaging; 89%, 76%, and 79% with FLAIR; and 100%, 74%, and 79% with CE-FIESTA, respectively.
Conclusion:
Our results suggest that a quantitative assessment using conventional T2W imaging or FLAIR may be a simple and useful method for predicting hard meningiomas.
Insights
Predicting meningioma consistency before surgery is crucial. This study found that T2-weighted (T2W) imaging and FLAIR sequences can quantitatively assess meningioma hardness, aiding surgical planning.
Area of Science:
- Neurosurgery
- Radiology
- Medical Imaging
Background:
- Accurate presurgical prediction of meningioma consistency is valuable for surgical planning.
- Understanding tumor characteristics preoperatively can optimize surgical approaches and outcomes.
Purpose of the Study:
- To quantitatively correlate magnetic resonance (MR) signal intensity (SI) and apparent diffusion coefficient (ADC) with meningioma consistency.
- To identify which MR sequences are most effective in predicting hard meningiomas.
Main Methods:
- 43 patients with meningiomas underwent preoperative MR imaging (MRI) including T1W, T2W, FLAIR, DWI, CE-T1W, and CE-FIESTA sequences.
- Tumor consistency was assessed using a visual analog scale (VAS) from 0 (soft) to 10 (hard).
- SI ratio and ADC values were compared with VAS scores to predict hard meningiomas (VAS ≥8).
Main Results:
- A significant negative correlation was found between tumor consistency and SI ratio on T2W, FLAIR, and CE-FIESTA sequences (P<0.05).
- T1W, CE-T1W, and ADC values did not show a significant correlation with tumor consistency.
- T2W imaging achieved 89% sensitivity, 79% specificity, and 81% accuracy for predicting hard meningiomas.
Conclusions:
- Quantitative assessment using conventional T2W imaging or FLAIR is a simple and effective method for predicting hard meningiomas.
- These MR sequences can aid surgeons in presurgical planning for meningioma resection.
