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Clinical metric for differentiating intracranial hemangiopericytomas from meningiomas using diffusion weighted MRI

Alexander M El-Ali1, Vikas Agarwal1, Andrew Thomas2

  • 1Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, Suite 200 East Wing, Pittsburgh, PA 15213, USA.

Clinical Imaging
|November 24, 2018
PubMed
Abstract

Insights

Diffusion weighted imaging (DWI) shows potential in differentiating intracranial hemangiopericytomas (IHP) from meningiomas. A normalized ADC ratio cutoff of >1.3 can help identify IHP, though sensitivity is limited.

Area of Science:

  • Neuroradiology
  • Oncology
  • Medical Imaging

Background:

  • Intracranial hemangiopericytomas (IHP) are dural-based tumors known for recurrence and metastasis.
  • Distinguishing IHP from meningiomas on imaging is challenging due to overlapping appearances.
  • Diffusion weighted imaging (DWI) offers potential for improved diagnostic accuracy.

Purpose of the Study:

  • To evaluate the efficacy of diffusion weighted imaging (DWI) in differentiating intracranial hemangiopericytomas (IHP) from meningiomas.
  • To compare imaging characteristics, specifically ADC values and normalized ADC ratios (nADC), between IHP and meningiomas.

Main Methods:

  • Retrospective analysis of MRI scans from 20 patients with IHP (WHO Grades II/III) and 48 patients with meningioma (WHO Grade I/II).
  • Comparison of apparent diffusion coefficient (ADC) values and normalized ADC ratios (nADC) between the two tumor groups.

Main Results:

  • ADC values were significantly different between IHP (1.05 × 10⁻³ mm²/s) and meningiomas (0.89 × 10⁻³ mm²/s) (p=0.05).
  • Normalized ADC ratios (nADC) also differed significantly, with IHP showing higher values (1.30) compared to meningiomas (1.07) (p=0.03).

Conclusions:

  • A normalized ADC ratio (nADC) cutoff of >1.3 demonstrated high specificity (96%) for identifying intracranial hemangiopericytomas.
  • While specific, this nADC cutoff exhibited low sensitivity (35%) for IHP detection, suggesting limitations in its standalone diagnostic utility.
Keywords:
Brain tumorDiffusion weighted imagingIntracranial hemangiopericytomaMRIMeningioma

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