Surov Alexey, Ginat Daniel T, Sanverdi Eser, Lim C C Tchoyoson, Hakyemez Bahattin, Yogi Akira, Cabada Teresa, Wienke Andreas
Department of Radiology, Martin-Luther-University, Halle-Wittenberg, Germany; Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany; University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA.
University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA.
World Neurosurg. 2016 Apr;88:598-602. doi: 10.1016/j.wneu.2015.10.049. Epub 2015 Oct 31.
Meningioma is the most frequent intracranial tumor and is often an incidental finding on imaging. Some imaging-based scores were suggested for differentiating low- and high-grade meningiomas. The purpose of this work was to compare diffusion-weighted imaging findings of different meningiomas in a large multicenter study by using apparent diffusion coefficient (ADC) values for predicting tumor grade and proliferation potential.
Data from 7 radiologic departments were acquired retrospectively. Overall, 389 patients were collected. All meningiomas were investigated by magnetic resonance imaging (1.5-T scanner) by using diffusion-weighted imaging (b values of 0 and 1000 s/mm(2)). The comparison of ADC values was performed by Mann-Whitney U test.
World Health Organization grade I was diagnosed in 271 cases (69.7%), grade II in 103 (26.5%), and grade III in 15 patients (3.9%). Grade I meningiomas showed statistically significant higher ADC values (1.05 ± 0.39 × 10(-3) mm(2)s(-1)) in comparison with grade II (0.77 ± 0.15 × 10(-3) mm(2)s(-1); P = 0.001) and grade III tumors (0.79 ± 0.21 × 10(-3) mm(2)s(-1); P = 0.01). An ADC value of <0.85 × 10(-3) mm(2)s(-1) was determined as the threshold in differentiating between grade I and grade II/III meningiomas (sensitivity, 72.9%; specificity, 73.1%; accuracy, 73.0%). Ki67 was associated with ADC (r = -0.63, P < 0.001). The optimal threshold for the ADC was (less than) 0.85 × 10(-3) mm(2)s(-1) for detecting tumors with high proliferation potential (Ki67 ≥5%).
The estimated threshold ADC value of 0.85 can differentiate grade I meningioma from grade II and III tumors. The same ADC value is helpful for detecting tumors with high proliferation potential.
脑膜瘤是最常见的颅内肿瘤，常在影像学检查时偶然发现。有人提出了一些基于影像学的评分系统来区分低级别和高级别脑膜瘤。本研究的目的是在一项大型多中心研究中，通过使用表观扩散系数（ADC）值比较不同脑膜瘤的扩散加权成像结果，以预测肿瘤级别和增殖潜能。
回顾性收集了7个放射科的数据。共纳入389例患者。所有脑膜瘤均采用1.5-T扫描仪进行磁共振成像检查，并使用扩散加权成像（b值为0和1000 s/mm²）。采用Mann-Whitney U检验比较ADC值。
世界卫生组织I级脑膜瘤271例（69.7%），II级103例（26.5%），III级15例（3.9%）。I级脑膜瘤的ADC值（1.05±0.39×10⁻³ mm²/s）在统计学上显著高于II级（0.77±0.15×10⁻³ mm²/s；P = 0.001）和III级肿瘤（P = 0.01）。将ADC值<0.85×10⁻³ mm²/s作为区分I级与II/III级脑膜瘤的阈值（敏感性为为72.9%；特异性为73.1%；准确性为73.0%）。Ki67与ADC相关（r = -0.63，P < 0.001）。检测增殖潜能高（Ki67≥5%）的肿瘤时，ADC的最佳阈值为<0.8×10⁻³ mm²/s。
估计的ADC阈值0.85可区分I级脑膜瘤与II级和III级肿瘤。相同的ADC值有助于检测增殖潜能高的肿瘤。
