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Meningioma assessment: Kinetic parameters in dynamic contrast-enhanced MRI appear independent from microvascular

Vera C Keil¹, Bogdan Pintea², Gerrit H Gielen³

¹Department of Radiology, University Hospital Bonn, Sigmund-Freud-Straße 25, 53127 Bonn, Germany.

Journal of Neuroradiology = Journal De Neuroradiologie

|February 8, 2018

Abstract

Background And Purpose:

Kinetic parameters of T1-weighted dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are considered to be influenced by microvessel environment. This study was performed to explore the extent of this association for meningiomas.

Materials And Methods:

DCE-MRI kinetic parameters (contrast agent transfer constants K^trans and k_ep, volume fractions v_p and v_e) were determined in pre-operative 3T MRI of meningioma patients for later biopsy sites (19 patients; 15 WHO I^o, no previous radiation, and 4 WHO III^o pre-radiated recurrent tumors). Sixty-three navigated biopsies were consecutively retrieved. Biopsies were immunohistochemically investigated with endothelial marker CD34 and VEGF antibodies, stratified in a total of 4383 analysis units and computationally assessed for VEGF expression and vascular parameters (vessel density, vessel quantity, vascular fraction within tissue [vascular area ratio], vessel wall thickness). Derivability of kinetic parameters from VEGF expression or microvascularization was determined by mixed linear regression analysis. Tissue kinetic and microvascular parameters were tested for their capacity to identify the radiation status in a subanalysis.

Results:

Kinetic parameters were neither significantly related to the corresponding microvascular parameters nor to tissue VEGF expression. There was no significant association between microvessel density and its presumed correlate v_p (P=0.07). The subgroup analysis of high-grade radiated meningiomas showed a significantly reduced microvascular density (AUC 0.91; P<0.0001) and smaller total vascular fraction (AUC 0.73; P=0.01).

Conclusions:

In meningioma, DCE-MRI kinetic parameters neither allow for a reliable prediction of tumor microvascularization, nor for a prediction of VEGF expression. Kinetic parameters seem to be determined from different independent factors.

Insights

Dynamic contrast-enhanced MRI (DCE-MRI) kinetic parameters do not reliably predict meningioma microvascularization or VEGF expression. These parameters appear to be influenced by factors independent of tumor vascularity.

Area of Science:

Neuro-oncology
Radiology
Pathology

Background:

T1-weighted dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) kinetic parameters are thought to reflect the tumor microvessel environment.
The association between DCE-MRI parameters and meningioma microvasculature requires further investigation.

Purpose of the Study:

To explore the association between DCE-MRI kinetic parameters and microvessel characteristics in meningiomas.
To determine if DCE-MRI parameters can predict tumor microvascularization and VEGF expression.

Main Methods:

DCE-MRI kinetic parameters (Ktrans, kep, vp, ve) were acquired in 3T MRI scans of 19 meningioma patients.
Sixty-three navigated biopsies were analyzed immunohistochemically for CD34, VEGF expression, and vascular parameters.
Mixed linear regression was used to assess the relationship between kinetic parameters, VEGF expression, and microvascularization.

Main Results:

No significant relationship was found between DCE-MRI kinetic parameters and microvascular parameters or tissue VEGF expression.
Microvessel density showed no significant association with the presumed correlate vp.
High-grade radiated meningiomas exhibited significantly reduced microvascular density and total vascular fraction.

Conclusions:

DCE-MRI kinetic parameters in meningiomas do not reliably predict tumor microvascularization or VEGF expression.
Kinetic parameters are likely influenced by factors independent of the tumor's microvascular environment.

Read full analysis

Keywords:

Dynamic contrast-enhanced MRI Kinetic parameters Meningioma Microvessels Vascular endothelial growth factor

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