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Susceptibility changes in meningiomas influence the apparent diffusion coefficient in diffusion-weighted MRI
L Schwyzer1, J Berberat2, L Remonda2
1Department of Neurosurgery/Brain Tumor Center, Cantonal Hospital Aarau, Tellstrasse, 5001 Aarau, Switzerland.
Introduction:
Cell-dense tumors may restrict diffusivity which can be measured by diffusion-weighted MRI (DWI), and which is quantified by the apparent diffusion coefficient (ADC). Little is known about diffusivity in meningiomas. These tumors frequently show hemorrhage and calcification which can be demonstrated using susceptibility weighted MRI (SWI). Both DWI and SWI represent T2-derived MRI sequences. Here we investigated ADC variability in meningiomas and analyzed whether susceptibility changes (SWIpos) alter diffusivity.
Methods:
We grouped newly diagnosed meningiomas according to the presence (SWIpos) or absence (SWIneg) of susceptibility changes. ADC values were calculated using region-of-interest analysis, and ADC values of SWIpos and SWIneg meningiomas were compared. In addition ADC histograms were created.
Results:
We retrospectively studied 36 patients (13 WHO grade I, 8 WHO grade II, 15 suspected meningiomas). Thirteen meningiomas (36%) exhibited SWIpos. Global ADC values were higher in SWIpos (1.00 ± 0.15 × 10-3mm(2)/s) compared to SWIneg (0.82 ± 0.09 × 10-3mm(2)/s) tumors (P<0.0001). Meningiomas showing both SWIpos and SWIneg areas caused two separated histogram peaks, whereas homogeneously appearing meningiomas with either SWIposor SWIneg areas showed one peak only. ADC values did not correlate with age or gender, and showed substantial overlap between WHO grade I and II.
Conclusion:
Susceptibility changes (SWIpos) in meningiomas influence measures of diffusivity by increasing ADC values on average by 38%. This shift has to be considered when conclusions on tumor behavior are drawn from DWI. Further studies should address whether ADC changes and histogram patterns can be used to monitor treatment of meningiomas.
Insights
Susceptibility changes in meningiomas significantly increase apparent diffusion coefficient (ADC) values, impacting diffusion-weighted MRI (DWI) interpretations. This finding is crucial for understanding tumor behavior and requires consideration in clinical assessments.
Area of Science:
- Neuroimaging
- Radiology
- Oncology
Background:
- Meningiomas can exhibit hemorrhage and calcification, detectable by susceptibility-weighted MRI (SWI).
- Diffusivity, measured by apparent diffusion coefficient (ADC) using diffusion-weighted MRI (DWI), is not well understood in meningiomas.
- Both DWI and SWI are T2-derived MRI sequences.
Purpose of the Study:
- To investigate apparent diffusion coefficient (ADC) variability in meningiomas.
- To analyze whether susceptibility changes (SWIpos) influence diffusivity measurements.
- To compare ADC values in meningiomas with and without susceptibility changes.
Main Methods:
- Retrospective analysis of 36 newly diagnosed meningiomas.
- Grouping tumors based on the presence (SWIpos) or absence (SWIneg) of susceptibility changes on SWI.
- Calculating and comparing global ADC values using region-of-interest analysis and creating ADC histograms.
Main Results:
- 36% of meningiomas showed susceptibility changes (SWIpos).
- SWIpos meningiomas had significantly higher global ADC values (1.00 ± 0.15 × 10-3mm²/s) compared to SWIneg tumors (0.82 ± 0.09 × 10-3mm²/s).
- Meningiomas with mixed SWI findings displayed two histogram peaks, while homogeneous tumors showed one peak.
Conclusions:
- Susceptibility changes (SWIpos) increase meningioma ADC values by approximately 38% on average.
- This ADC elevation must be considered when interpreting DWI findings for tumor behavior.
- Further research is needed to explore ADC changes and histogram patterns for meningioma treatment monitoring.
