Diagnostic value of apparent diffusion coefficient for the accurate assessment and differentiation of intracranial meningiomas

Abstract

BackgroundDiffusion-weighted imaging (DWI) along with the calculation of apparent diffusion coefficient (ADC), is a novel, non-invasive, and reliable technique of choice for accurate assessment and for the treatment planning of different types of brain tumors. It is more advantageous in the distinction and differentiation of benign from malignant meningiomas on the basis of ADC values.PurposeTo investigate the utility of DW magnetic resonance imaging (MRI), and to compare the apparent diffusion coefficient (ADC) obtained at two b-values for an authentic and preoperative characterization of meningiomas.Material and MethodsTwenty-six patients with clinically diagnosed or histologically verified meningioma (18 benign and 8 malignant) underwent imaging including DWI at 1.5 T. DW images were obtained at b = 1000 s/mm2 and b = 2000 s/mm2, ADC maps were generated at both the b-values. Signal intensities (SIs) and ADCs for solid tumorous tissues, contralateral normal tissues, and peritumoral edema were calculated and normalized ADC (NADC) ratio were determined for tumorous tissues. SI scores, ADC maps, and ADC values were analyzed visually and quantitatively, and were compared at both the b-values.ResultsDW images at b = 2000 s/mm2 were more conspicuity (either hyperintense or hypointense) with improved contrast. The mean ADC of malignant meningiomas (0.64 ± 0.05 and 0.42 ± 0.03) was significantly lower (P < 0.05) as compared with benign meningiomas (1.04 ± 0.12 and 0.80 ± 0.07) at both the b-values. Mean NADC ratio in the malignant type was also significantly lower (P < 0.05) than the benign type at both the b-values. Mean ADC values for peritumoral edema do not differ between benign and malignant meningiomas.Conclusion1.5-T DWI using high b-values improved our ability to differentiate benign from malignant meningiomas. DWI may play an important role in the preoperative radiological evaluation and the recognition of these types for proper surgical treatment.

Is Apparent Diffusion Coefficient Value Measured on Picture Archiving and Communication System Workstation Helpful in Prediction of High-grade Meningioma?

“…6 Many studies have reported that the mean ADC values of benign meningioma are higher than the mean ADC values of atypical/malignant meningioma. 2,[5][6][7]9 Our results were in agreement with previous studies that report a significant statistical difference in ADC value of atypical / malignant and benign meningiomas. 2,[5][6][7]10 The mean ADC value of atypical and malignant meningiomas in our study was significantly lower compared with that of benign meningiomas (0.698 x 10 -3 mm 2 /s ± 0.06 x 10 -3 mm 2 /s vs. 0.83 x 10 -3 mm 2 /s ± 0.37 x 10 -3 mm 2 /s).…”

“…Heterogeneous enhancement and irregular cerebral surface that may help differentiate the two groups 4 are still not consistent and unique neuroimaging features for diagnosing malignant meningiomas. 5 Diffusion-weighted imaging (DWI) along with the calculation of apparent diffusion coefficient (ADC) have been reported to be a non-invasive and reliable technique in the distinction and differentiation of benign from malignant / atypical meningiomas on the basis of ADC maps and ADC value. 2,[5][6][7] Most publications, however, calculated ADC value on a separate specialised workstation.…”

“…5 Diffusion-weighted imaging (DWI) along with the calculation of apparent diffusion coefficient (ADC) have been reported to be a non-invasive and reliable technique in the distinction and differentiation of benign from malignant / atypical meningiomas on the basis of ADC maps and ADC value. 2,[5][6][7] Most publications, however, calculated ADC value on a separate specialised workstation. 2,[5][6][7] To the best of our knowledge, no publication has discussed calculation of ADC value in meningioma using a routine picture archiving and communication system (PACS) workstation.…”

“…2,[5][6][7] Most publications, however, calculated ADC value on a separate specialised workstation. 2,[5][6][7] To the best of our knowledge, no publication has discussed calculation of ADC value in meningioma using a routine picture archiving and communication system (PACS) workstation. ADC value measured in liver nodules on a PACS workstation has already been reported to be as accurate as the value obtained on a dedicated specialised workstation and should also be applied to lesions elsewhere in the body.…”

Ekstraaksiyel Beyin Tumorleri

“…Artmış mitotik aktivite, nekroz, yüksek nükleus sitoplazma oranı ve kesintisiz hücre büyümesi yüksek dereceli menenjiomlarda izlenir ki bu da kısıtlanmış su difüzyonu ve düşük ADC değerleri ile sonuçlanır [2]. Bununla birlikte bazı çalışmalarda atipik/malign menenjiomlarda benign menenjiomlara göre daha düşük ADC değerleri izlenmişken bazı çalışmalarda anlamlı farklılık saptanmamıştır [36][37][38][39][40][41][42]. Ayrıca menenjiomlarda yüksek dereceli gliomlara göre düşük ADC izlenir [18].…”