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Evaluation parameters between intra-voxel incoherent motion and diffusion-weighted imaging in grading and
Lu Yiping1, Shek Kawai2, Wen Jianbo1
1Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai 200040, China.
Purpose:
To prospectively evaluate the usage of intra-voxel incoherent motion (IVIM) magnetic resonance imaging (MRI) parameters in grading and differentiating histological subtypes of meningiomas and in comparing their ability with the traditional diffusion-weighted imaging (DWI) parameter (apparent diffusion coefficient, ADC).
Methods:
In this prospective study, 102 participants underwent IVIM MRI and DWI. Traditional DWI and IVIM MRI were performed by using 2 b values (0, 1000s/mm2) and 12 b values (0-3500s/mm2), respectively. Finally, the values of ADC and IVIM parameters were collected from 72 Grade I and 11 Grade II meningiomas.
Results:
The mean ADC values of Grade II and Grade I meningiomas were 0.909±0.268×10-3mm2/s and 0.905±0.194×10-3mm2/s, respectively, p=0.967. The D values were lower in Grade II meningiomas than in Grade I meningiomas (0.459±0.072×10-3mm2/s vs. 0.524±0.030×10-3mm2/s, respectively, p=0.005). In ROC curves, the cut-off D value that separated Grade II meningiomas from Grade I meningiomas was 0.479×10-3mm2/s with a sensitivity of 90.9% and a specificity of 76.7%. The secretory and angiomatous meningiomas had higher IVIM parameters than the other subtypes (all p<0.05). D* was significantly lower in fibrous meningiomas than in other meningiomas (2.783±1.179×10-3mm2/s vs. 5.125±1.918×10-3mm2/s, p<0.001). D, rD and rf values correlated negatively with Ki-67 index while D* and rD* value had positive relation with Ki-67 values.
Conclusion:
IVIM MRI is a promising technique for distinguishing different grades of meningiomas. Different subtypes of meningiomas have different IVIM features, which may help to treatment decision and prognosis evaluation.
Insights
Intra-voxel incoherent motion (IVIM) magnetic resonance imaging (MRI) shows promise in grading meningiomas, outperforming traditional apparent diffusion coefficient (ADC) measures. IVIM parameters also help differentiate meningioma subtypes, aiding treatment decisions.
Area of Science:
- Neuroradiology
- Oncology Imaging
- Diffusion MRI Techniques
Background:
- Meningiomas are the most common primary intracranial tumors.
- Accurate grading and subtyping are crucial for treatment planning and prognosis.
- Traditional diffusion-weighted imaging (DWI) using apparent diffusion coefficient (ADC) has limitations in differentiating meningioma grades.
Purpose of the Study:
- To evaluate intra-voxel incoherent motion (IVIM) MRI parameters for grading and differentiating meningioma histological subtypes.
- To compare the efficacy of IVIM parameters against traditional ADC values in meningioma characterization.
Main Methods:
- A prospective study involving 102 participants undergoing both IVIM MRI and DWI.
- IVIM MRI utilized 12 b-values (0-3500s/mm²), while traditional DWI used 2 b-values (0, 1000s/mm²).
- ADC and IVIM parameters were analyzed for 72 Grade I and 11 Grade II meningiomas.
Main Results:
- Mean ADC values did not significantly differ between Grade II and Grade I meningiomas (p=0.967).
- IVIM parameter D was significantly lower in Grade II meningiomas compared to Grade I (p=0.005), with a cut-off value of 0.479×10⁻³mm²/s showing 90.9% sensitivity and 76.7% specificity.
- Specific meningioma subtypes (secretory, angiomatous) exhibited distinct IVIM features, and correlations with Ki-67 index were observed for D, rD, rf, D*, and rD* values.
Conclusions:
- IVIM MRI is a valuable tool for distinguishing between different grades of meningiomas.
- Distinct IVIM characteristics of meningioma subtypes can inform treatment strategies and prognosis evaluation.
