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Amide proton transfer imaging for differentiation of benign and atypical meningiomas
Bio Joo1, Kyunghwa Han2, Yoon Seong Choi2
1Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Gyeonggi-do, Korea.
Purpose:
To investigate the difference in amide proton transfer (APT)-weighted signals between benign and atypical meningiomas and determine the value of APT imaging for differentiating the two.
Methods:
Fifty-seven patients with pathologically diagnosed meningiomas (benign, 44; atypical, 13), who underwent preoperative MRI with APT imaging between December 2014 and August 2016 were included. We compared normalised magnetisation transfer ratio asymmetry (nMTR asym ) values between benign and atypical meningiomas on APT-weighted images. Conventional MRI features were qualitatively assessed. Both imaging features were evaluated by multivariable logistic regression analysis. The discriminative value of MRI with and without nMTR asym was evaluated.
Results:
The nMTR asym of atypical meningiomas was significantly greater than that of benign meningiomas (2.46% vs. 1.67%; P < 0.001). In conventional MR images, benign and atypical meningiomas exhibited significant differences in maximum tumour diameter, non-skull base location, and heterogeneous enhancement. On multivariable logistic regression analysis, high nMTR asym was an independent predictor of atypical meningiomas (adjusted OR, 11.227; P = 0.014). The diagnostic performance of MRI improved with nMTR asym for predicting atypical meningiomas.
Conclusion:
Atypical meningiomas exhibited significantly higher APT-weighted signal intensities than benign meningiomas. The discriminative value of conventional MRI improved significantly when combined with APT imaging for diagnosis of atypical meningioma.
Key Points:
• APT imaging is useful for differentiating between atypical and benign meningiomas. • Atypical meningiomas exhibited high APT-weighted signal intensity than benign meningiomas. • The diagnostic performance of MRI improved with nMTR asym for predicting atypical meningiomas.
Insights
Amide proton transfer (APT) imaging reveals higher signal intensities in atypical meningiomas compared to benign ones. Combining APT imaging with conventional MRI significantly improves the diagnostic accuracy for atypical meningiomas.
Area of Science:
- Neuroradiology
- Medical Imaging
- Oncology
Background:
- Meningiomas are the most common primary intracranial tumors.
- Differentiating between benign and atypical meningiomas preoperatively is crucial for treatment planning.
- Conventional MRI has limitations in distinguishing these subtypes.
Purpose of the Study:
- To evaluate the efficacy of amide proton transfer (APT)-weighted imaging in differentiating benign from atypical meningiomas.
- To determine the diagnostic value of APT imaging in conjunction with conventional MRI features.
Main Methods:
- A retrospective analysis of 57 patients with pathologically confirmed meningiomas (44 benign, 13 atypical) who underwent preoperative MRI with APT imaging.
- Comparison of normalized magnetisation transfer ratio asymmetry (nMTRasym) values between benign and atypical meningiomas.
- Multivariable logistic regression analysis incorporating conventional MRI features and nMTRasym.
Main Results:
- Atypical meningiomas demonstrated significantly higher nMTRasym values (2.46%) compared to benign meningiomas (1.67%; P < 0.001).
- High nMTRasym was identified as an independent predictor of atypical meningiomas (adjusted OR, 11.227; P = 0.014).
- The diagnostic performance of MRI for predicting atypical meningiomas improved when nMTRasym was included.
Conclusions:
- APT imaging is a valuable tool for distinguishing between atypical and benign meningiomas.
- Atypical meningiomas exhibit significantly higher APT-weighted signal intensities.
- The combination of APT imaging with conventional MRI enhances diagnostic accuracy for atypical meningioma detection.
