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Histogram Analysis Parameters Apparent Diffusion Coefficient for Distinguishing High and Low-Grade Meningiomas: A

Alexey Surov1, Daniel T Ginat2, Tchoyoson Lim3

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Apparent diffusion coefficient (ADC) histogram analysis can help differentiate meningioma grades. Lower ADC median values in higher-grade tumors suggest potential for predicting tumor grade and proliferation.

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Area of Science:

  • Neuroradiology
  • Oncology
  • Medical Imaging

Background:

  • Meningiomas are tumors arising from the meninges.
  • Tumor grade significantly impacts prognosis, with low-grade meningiomas having a better outlook than high-grade ones.
  • Accurate grading is crucial for treatment planning and predicting patient outcomes.

Purpose of the Study:

  • To evaluate apparent diffusion coefficient (ADC) histogram analysis parameters in a multicenter cohort of meningiomas.
  • To assess the utility of these parameters in predicting tumor grade and proliferation potential (Ki-67).

Main Methods:

  • Retrospective analysis of 148 meningiomas from 7 institutions.
  • MRI with diffusion-weighted imaging (b=0 and 1000 s/mm²) was performed on 1.5 T scanners.
  • Calculation of various ADC histogram parameters (mean, median, mode, percentiles, kurtosis, skewness, entropy) and correlation with Ki-67 index.

Main Results:

  • Grade 2/3 meningiomas exhibited significantly lower ADC histogram parameters compared to Grade 1 tumors, particularly the ADC median.
  • An ADC median threshold of 0.82 demonstrated good accuracy (76.4%) in differentiating tumor grades.
  • Most ADC parameters showed weak but significant correlations with the Ki-67 proliferation index, with ADC P25 being notably correlated.

Conclusions:

  • ADC histogram analysis is a valuable, non-invasive tool for predicting meningioma grade.
  • ADC median is a promising parameter for distinguishing between low-grade and high-grade meningiomas.
  • ADC parameters may offer insights into tumor proliferation, although correlations with Ki-67 are generally weak.