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Apparent Diffusion Coefficient in Predicting the Preoperative Grade of Meningiomas
Basak Atalay1, Suna Sahin Ediz2, Nurver Ozel Ozbay3
1Department of Radiology, Istanbul Medeniyet University, School of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey.
Objective:
To investigate the relationship between the apparent diffusion coefficients (ADC) value obtained from magnetic resonance imaging (MRI) and histopathologic grade of meningiomas.
Study Design:
Observational study.
Place And Duration Of Study:
Department of Radiology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey between January 2015 and June 2019.
Methodology:
Data of 45 patients with meningiomas, who underwent surgery at the University Hospital, were retrospectively reviewed; 28 patients were enrolled in the study. The pathology preparations of the patients were re-evaluated according to the World Health Organisation (WHO) 2016 classification updated by a neuropathologist. ADC values were measured in a standard region of interest range from the three consecutive sections where the mass had the largest width and from the opposite white matter.
Results:
Fourteen patients (50%) were diagnosed with WHO grade I tumor, 11 with grade II (39.3%), and three with grade III (10.7%). The ADCmin value was found statistically significant for the differentiation of tumor grades (p = 0.018). The cut-off point of the ADCmin value was 0.634x10-3mm2s for the differential diagnosis of grade I and grade II/III meningiomas. The sensitivity of the cut-off value was found as 86% and its specificity as 57%. The patients with increased cellularity and Ki67 proliferation index had statistically significantly lower ADCmin values (p = 0.025).
Conclusion:
The data of this study show a significant difference in the ADCmin values on MRI between low- and high-grade meningiomas. A negative correlation was found between histopathologic grade and ADCmin. Key Words: Meningioma, Apparent diffusion coefficient, Magnetic resonance imaging, Histopathological grade, Quantitative.
Insights
Apparent diffusion coefficient (ADC) values from MRI can help differentiate meningioma grades. Lower ADCmin values correlate with higher tumor grade, aiding in diagnosis.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Meningiomas are the most common primary intracranial tumors.
- Accurate grading of meningiomas is crucial for treatment planning and prognosis.
- Distinguishing between low- and high-grade meningiomas can be challenging with conventional imaging.
Purpose of the Study:
- To investigate the relationship between apparent diffusion coefficient (ADC) values from MRI and the histopathologic grade of meningiomas.
- To determine if ADC values can serve as a quantitative marker for meningioma grading.
Main Methods:
- Retrospective review of 28 meningioma cases.
- Histopathologic re-evaluation according to WHO 2016 classification.
- Measurement of ADC values in regions of interest on MRI scans.
Main Results:
- A statistically significant difference in ADCmin values was observed between different meningioma grades (p = 0.018).
- A cut-off ADCmin value of 0.634x10-3mm2s showed 86% sensitivity and 57% specificity for differentiating grade I from grade II/III meningiomas.
- Lower ADCmin values were significantly associated with increased cellularity and Ki67 proliferation index (p = 0.025).
Conclusions:
- ADCmin values on MRI show a significant difference between low- and high-grade meningiomas.
- A negative correlation exists between histopathologic grade and ADCmin values.
- ADCmin may be a valuable quantitative tool for non-invasively assessing meningioma grade.
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