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Preoperative assessment of meningioma grade using ADC ratios: A multi-observer analytical approach
Antonio Navarro-Ballester1, Rosa Álvaro-Ballester1, Miguel A Lara-Martínez1
1Department of Radiology, General University Hospital of Castellón, Castellón, Spain.
Background:
Meningiomas are common primary intracranial tumors with varying biological behavior. Accurate preoperative grading is essential for surgical planning and patient management.
Purpose:
To evaluate the diagnostic performance and interobserver agreement of apparent diffusion coefficient (ADC) values and ADC ratios in differentiating low-grade and high-grade meningiomas using 1.5T MRI.
Materials And Methods:
This retrospective single-center study included 155 patients with histologically confirmed meningiomas. Three independent observers measured ADC values and calculated ADC ratios using ROI analysis. Diagnostic performance was assessed using ROC curves, and interobserver agreement was evaluated using intraclass correlation coefficients (ICC).
Results:
Mean ADC values showed poor diagnostic performance (AUCs: 0.39-0.44). ADC ratios showed slightly better interobserver agreement (ICC = 0.78) but similarly weak diagnostic value (AUCs: 0.38-0.42). Differences among observers were not statistically significant (p = 0.0668).
Conclusion:
Both mean ADC values and ADC ratios demonstrated poor performance in differentiating meningioma grades. Despite moderate interobserver agreement, neither parameter was clinically useful. Alternative imaging biomarkers or multimodal approaches may be needed for reliable non-invasive grading.
