Use of MRI Apparent Diffusion Coefficient to Noninvasively Differentiate between the Histologic Grades of Meningioma

M, Neethu P.; P, Saanida M.; Subramaniam, Gomathi; Devarajan, E; Naufal, P; Juvaina, P

doi:10.14260/jemds/2020/369

Cited by 1 publication

(2 citation statements)

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“…Therefore, an inverse correlation has been reported between ADC value and tumor cellularity due to this effect. (16) The sensitivity in this study was 63.6%, which was lower than that in the previous studies conducted by Abdel-Kerim et al (17) and Neethu et al, (18) namely 81.2% and 84.0%, respectively. A low sensitivity can be due to the number of benign and malignant subjects, as in the study by Abdel-Kerim et al (17) with 36 benign and 11 malignant samples, and in the study by Neethu et al (18) with 53 benign and 13 malignant samples.…”

Section: Discussioncontrasting

confidence: 72%

“…(16) The sensitivity in this study was 63.6%, which was lower than that in the previous studies conducted by Abdel-Kerim et al (17) and Neethu et al, (18) namely 81.2% and 84.0%, respectively. A low sensitivity can be due to the number of benign and malignant subjects, as in the study by Abdel-Kerim et al (17) with 36 benign and 11 malignant samples, and in the study by Neethu et al (18) with 53 benign and 13 malignant samples. Another source of low sensitivity is the high average malignant ADC value close to the cutoff point, because the area of necrosis in malignant meningioma causes increasing fluid diffusion.…”

Section: Discussioncontrasting

confidence: 72%

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The diagnostic value of apparent diffusion coefficient to differentiate benign and malignant meningiomas

et al. 2021

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BACKGROUNDMeningiomas are the most common primary extra-axial non-glial intracranial tumors. The severe grade of meningioma, according to WHO, has the highest recurrence rate accompanied by high morbidity and mortality rates. Therefore, it is imperative to perform pre-operative assessments so the clinician can give prompt treatment to gain a better prognosis. It is a novel alternative way of predicting meningioma’s malignancy by calculating the tumor’s apparent diffusion coefficient (ADC) value. The objective of the study was to determine the value of ADC for differentiating benign and malignant meningiomas. METHODSThis cross-sectional study involved 32 subjects with clinically diagnosed or histologically verified meningioma (21 benign and 11 malignant). They underwent a head-magnetic resonance imaging (MRI) examination and biopsy. We calculated the ADC value by creating regions of interest (ROIs) on the solid part of the tumor, guided by contrast and fluid-attenuated inversion recovery (FLAIR) sequence. We analyzed the ADC value with independent t-test and Bland-Altman graphs, calculated the average difference, CI 95%, limit of agreement between observers, and ROC. RESULTSMean ADC of malignant meningiomas (0.877 ± 0.167 x 10-3 mm2/s) was significantly lower than that of benign meningiomas (0.990 ± 0.105 x 10-3 mm2/s) (p<0.05). The ADC threshold is 0.886 x 10-3 mm2/s with sensitivity 63.6%, specificity 85.7%, positive predictive value 70% and negative predictive value 81.8%. CONCLUSIONThe ADC value measurement provides a discriminative feature to differentiate between benign and malignant meningiomas. However, the clinical applicability still needs to be elucidated, as histopathological confirmation remains the mainstay of definitive diagnosis.

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Section: Discussioncontrasting

confidence: 72%