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Erschienen in: Neuroradiology 11/2020

24.06.2020 | Diagnostic Neuroradiology

Multi-parametric qualitative and quantitative MRI assessment as predictor of histological grading in previously treated meningiomas

verfasst von: Simone Sacco, Francesco Ballati, Clara Gaetani, Pascal Lomoro, Lisa Maria Farina, Ana Bacila, Sara Imparato, Chiara Paganelli, Giulia Buizza, Alberto Iannalfi, Guido Baroni, Francesca Valvo, Stefano Bastianello, Lorenzo Preda

Erschienen in: Neuroradiology | Ausgabe 11/2020

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Abstract

Purpose

Meningiomas are mainly benign tumors, though a considerable proportion shows aggressive behaviors histologically consistent with atypia/anaplasia. Histopathological grading is usually assessed through invasive procedures, which is not always feasible due to the inaccessibility of the lesion or to treatment contraindications. Therefore, we propose a multi-parametric MRI assessment as a predictor of meningioma histopathological grading.

Methods

Seventy-three patients with 74 histologically proven and previously treated meningiomas were retrospectively enrolled (42 WHO I, 24 WHO II, 8 WHO III) and studied with MRI including T2 TSE, FLAIR, Gradient Echo, DWI, and pre- and post-contrast T1 sequences. Lesion masks were segmented on post-contrast T1 sequences and rigidly registered to ADC maps to extract quantitative parameters from conventional DWI and intravoxel incoherent motion model assessing tumor perfusion. Two expert neuroradiologists assessed morphological features of meningiomas with semi-quantitative scores.

Results

Univariate analysis showed different distributions (p < 0.05) of quantitative diffusion parameters (Wilcoxon rank-sum test) and morphological features (Pearson’s chi-square; Fisher’s exact test) among meningiomas grouped in low-grade (WHO I) and higher grade forms (WHO II/III); the only exception consisted of the tumor-brain interface. A multivariate logistic regression, combining all parameters showing statistical significance in the univariate analysis, allowed discrimination between the groups of meningiomas with high sensitivity (0.968) and specificity (0.925). Heterogeneous contrast enhancement and low ADC were the best independent predictors of atypia and anaplasia.

Conclusion

Our multi-parametric MRI assessment showed high sensitivity and specificity in predicting histological grading of meningiomas. Such an assessment may be clinically useful in characterizing lesions without histological diagnosis.
Key points
When surgery and biopsy are not feasible, parameters obtained from both conventional and diffusion-weighted MRI can predict atypia and anaplasia in meningiomas with high sensitivity and specificity.
Low ADC values and heterogeneous contrast enhancement are the best predictors of higher grade meningioma
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Metadaten
Titel
Multi-parametric qualitative and quantitative MRI assessment as predictor of histological grading in previously treated meningiomas
verfasst von
Simone Sacco
Francesco Ballati
Clara Gaetani
Pascal Lomoro
Lisa Maria Farina
Ana Bacila
Sara Imparato
Chiara Paganelli
Giulia Buizza
Alberto Iannalfi
Guido Baroni
Francesca Valvo
Stefano Bastianello
Lorenzo Preda
Publikationsdatum
24.06.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Neuroradiology / Ausgabe 11/2020
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-020-02476-y

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