Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
Department of Radiology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, 350014, China.
Eur Radiol. 2023 Jan;33(1):258-269. doi: 10.1007/s00330-022-09026-5. Epub 2022 Aug 12.
To investigate the value of histogram analysis of T1 mapping and diffusion-weighted imaging (DWI) in predicting the grade, subtype, and proliferative activity of meningioma.
This prospective study comprised 69 meningioma patients who underwent preoperative MRI including T1 mapping and DWI. The histogram metrics, including mean, median, maximum, minimum, 10th percentiles (C10), 90th percentiles (C90), kurtosis, skewness, and variance, of T1 and apparent diffusion coefficient (ADC) values were extracted from the whole tumour and peritumoural oedema using FeAture Explorer. The Mann-Whitney U test was used for comparison between low- and high-grade tumours. Receiver operating characteristic (ROC) curve and logistic regression analyses were performed to identify the differential diagnostic performance. The Kruskal-Wallis test was used to further classify meningioma subtypes. Spearman's rank correlation coefficients were calculated to analyse the correlations between histogram parameters and Ki-67 expression.
High-grade meningiomas showed significantly higher mean, maximum, C90, and variance of T1 (p = 0.001-0.009), lower minimum, and C10 of ADC (p = 0.013-0.028), compared to low-grade meningiomas. For all histogram parameters, the highest individual distinctive power was T1 C90 with an AUC of 0.805. The best diagnostic accuracy was obtained by combining the T1 C90 and ADC C10 with an AUC of 0.864. The histogram parameters differentiated 4/6 pairs of subtype pairs. Significant correlations were identified between Ki-67 and histogram parameters of T1 (C90, mean) and ADC (C10, kurtosis, variance).
T1 and ADC histogram parameters may represent an in vivo biomarker for predicting the grade, subtype, and proliferative activity of meningioma.
• The histogram parameter based on T1 mapping and DWI is useful to preoperatively evaluate the grade, subtype, and proliferative activity of meningioma. • The combination of T1 C90 and ADC C10 showed the best performance for differentiating low- and high-grade meningiomas.
探讨 T1 映射和弥散加权成像（DWI）直方图分析在预测脑膜瘤分级、亚型和增殖活性中的价值。
本前瞻性研究纳入了 69 例接受术前 MRI 包括 T1 映射和 DWI 的脑膜瘤患者。使用 FeAture Explorer 从整个肿瘤和瘤周水肿中提取 T1 和表观弥散系数（ADC）值的直方图指标，包括平均值、中位数、最大值、最小值、第 10 百分位数（C10）、第 90 百分位数（C90）、峰度、偏度和方差。采用 Mann-Whitney U 检验比较低级别和高级别肿瘤之间的差异。采用受试者工作特征（ROC）曲线和逻辑回归分析来确定鉴别诊断性能。采用 Kruskal-Wallis 检验进一步对脑膜瘤亚型进行分类。采用 Spearman 秩相关系数分析直方图参数与 Ki-67 表达的相关性。
高级别脑膜瘤的 T1 平均值、最大值、C90 和方差显著高于低级别脑膜瘤（p=0.001-0.009），ADC 的最小值和 C10 显著低于低级别脑膜瘤（p=0.013-0.028）。对于所有直方图参数，T1 C90 的个体鉴别能力最高，AUC 为 0.805。T1 C90 和 ADC C10 的结合获得了最佳的诊断准确性，AUC 为 0.864。直方图参数可区分 6 对亚型对中的 4 对。Ki-67 与 T1（C90、平均值）和 ADC（C10、峰度、方差）的直方图参数之间存在显著相关性。
T1 和 ADC 直方图参数可能是预测脑膜瘤分级、亚型和增殖活性的一种体内生物标志物。
• T1 映射和 DWI 的直方图参数有助于术前评估脑膜瘤的分级、亚型和增殖活性。
• T1 C90 和 ADC C10 的组合在区分低级别和高级别脑膜瘤方面表现最佳。
