The role of three-dimensional pseudo-continuous arterial spin labelling in grading and differentiating histological
1Department of Radiology, Huashan Hospital, Fudan University, 12(th) Middle Wulumuqi Road, Jingan District, Shanghai, China.
Aim:
To evaluate the usefulness of pseudo-continuous arterial spin labelling (pCASL) imaging in grading and differentiating histological subtypes of meningiomas.
Materials And Methods:
In this prospective study, conventional magnetic resonance imaging (MRI) with contrast-enhanced T1-weighted images and pCASL were acquired with a 3 T MRI system before surgery in 125 consecutive patients with suspected meningiomas. Finally, the perfusion parameters were collected from 84 grade I and 23 grade II meningiomas. On the pCASL perfusion map, the mean absolute cerebral blood flow (CBF) values from the meningioma (CBFtumour), peritumoural oedema (CBFPTO), white matter of contralateral centrum semi-ovale (CBFwm) and normal grey matter (CBFgm) were calculated. Additionally, the associations of these perfusion parameters with the value of ki-67 index were analysed.
Results:
The CBFwm value correlated negatively with the largest diameter of the tumour, which limited its usage as a reference for ratio calculation. The CBFtumour values of grade II and grade I meningiomas did not differ significantly: 137.36±71.85 ml/min/100 g versus 123.58±135.80 ml/min/100 g (p=0.641). The CBFPTO value was higher for grade II meningioma as than for grade I meningiomas: 30.30±15.56 ml/min/100 g versus 22.33±9.87 ml/min/100 g (p=0.037). The CBFtumour value was highest in angiomatous meningioma and lowest in fibrous meningioma, thus enabling the differentiation of subtypes of meningioma. The CBFtumour value did not correlate with the ki-67 index of meningioma.
Conclusion:
The CBFPTO value, rather than the CBFtumour value, from pCASL imaging may serve as a key factor in distinguishing different grades of meningiomas. Moreover, angiomatous meningiomas and fibrous meningiomas can be identified by CBFtumour value.
Insights
Pseudo-continuous arterial spin labelling (pCASL) imaging helps differentiate meningioma grades and subtypes. Peritumoural oedema (CBFPTO) values distinguish grades, while tumour (CBFtumour) values identify specific subtypes like angiomatous and fibrous meningiomas.
Area of Science:
- Neuroimaging
- Oncology
- Radiology
Background:
- Meningiomas are the most common primary intracranial tumors.
- Accurate grading and subtyping are crucial for treatment planning and prognosis.
- Non-invasive imaging techniques are needed to complement histopathology.
Purpose of the Study:
- To assess the utility of pseudo-continuous arterial spin labelling (pCASL) in grading meningiomas.
- To evaluate pCASL's ability to differentiate histological subtypes of meningiomas.
- To correlate perfusion parameters with tumor grade and ki-67 index.
Main Methods:
- Prospective study involving 125 patients with suspected meningiomas.
- Acquisition of conventional MRI and pCASL at 3T.
- Calculation of cerebral blood flow (CBF) values: CBFtumour, CBFPTO, CBFwm, CBFgm.
- Analysis of perfusion parameters in 84 grade I and 23 grade II meningiomas.
Main Results:
- CBFPTO was significantly higher in grade II compared to grade I meningiomas (p=0.037).
- CBFtumour values did not significantly differ between grades I and II.
- CBFtumour values varied among subtypes, differentiating angiomatous and fibrous meningiomas.
- No significant correlation was found between CBFtumour and the ki-67 index.
Conclusions:
- pCASL-derived CBFPTO is a potential biomarker for distinguishing meningioma grades.
- pCASL-derived CBFtumour can aid in identifying specific meningioma subtypes.
- pCASL offers a non-invasive method for characterizing meningiomas.
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