1 Department of Radiology, Buffalo VA Medical Center, 3495 Bailey Ave, Buffalo, NY 14215.
AJR Am J Roentgenol. 2014 Jun;202(6):1303-8. doi: 10.2214/AJR.13.11637.
A noninvasive method to predict aggressiveness of high-grade meningiomas would be desirable because it would help anticipate tumor recurrence and improve tumor management and the treatment outcomes. The Ki-67 protein is a marker of tumor proliferation, and apparent diffusion coefficient (ADC) is related to tumor cellularity. Therefore, we sought to determine whether there is a statistically significant correlation between ADC and Ki-67 values in meningiomas and whether ADC values can differentiate various meningioma subtypes.
MRI examinations and histopathology of 68 surgically treated meningiomas were retrospectively reviewed. Mean ADC values were derived from diffusion imaging. Correlation coefficients were calculated for mean ADC and Ki-67 proliferation index values using linear regression. An independent unpaired Student t test was used to compare the ADC and Ki-67 proliferation index values from low-grade and more aggressive meningiomas.
A statistically significant inverse correlation was found between ADC and Ki-67 proliferation index for low-grade and aggressive meningiomas (r(2) = -0.33, p = 0.0039). ADC values (± SD) of low-grade meningiomas (0.84 ± 0.14 × 10(-3) mm(2)/s) and aggressive (atypical or anaplastic) meningiomas (0.75 ± 0.03 × 10(-3) mm(2)/s) were significantly different (p = 0.0495). Using an ADC cutoff value of 0.70 × 10(-3) mm(2)/s, the sensitivity for diagnosing aggressive meningiomas was 29%, specificity was 94%, positive predictive value was 67%, and negative predictive value was 75%.
ADC values correlate inversely with Ki-67 proliferation index and help differentiate low-grade from aggressive meningiomas.
寻找一种非侵入性的方法来预测高级别脑膜瘤的侵袭性是很有必要的，因为它有助于预测肿瘤复发，并改善肿瘤管理和治疗效果。Ki-67 蛋白是肿瘤增殖的标志物，而表观扩散系数（ADC）与肿瘤细胞密度有关。因此，我们试图确定 ADC 值与脑膜瘤的 Ki-67 值之间是否存在统计学上的显著相关性，以及 ADC 值是否可以区分不同的脑膜瘤亚型。
回顾性分析了 68 例经手术治疗的脑膜瘤的 MRI 检查和组织病理学结果。从弥散成像中得出平均 ADC 值。使用线性回归计算平均 ADC 值和 Ki-67 增殖指数值的相关系数。使用独立的配对 t 检验比较低级别和侵袭性脑膜瘤的 ADC 值和 Ki-67 增殖指数值。
低级别和侵袭性脑膜瘤的 ADC 值与 Ki-67 增殖指数之间存在统计学上的显著负相关（r²=-0.33，p=0.0039）。低级别脑膜瘤（0.84±0.14×10⁻³mm²/s）和侵袭性（非典型或间变性）脑膜瘤（0.75±0.03×10⁻³mm²/s）的 ADC 值（±SD）有显著差异（p=0.0495）。使用 ADC 截断值为 0.70×10⁻³mm²/s，诊断侵袭性脑膜瘤的灵敏度为 29%，特异性为 94%，阳性预测值为 67%，阴性预测值为 75%。
ADC 值与 Ki-67 增殖指数呈负相关，可以帮助区分低级别和侵袭性脑膜瘤。
