Apparent Diffusion Coefficient Values and Intra-tumoral Susceptibility Signals in Meningiomas and Schwannomas: Useful Tools for Challenging Cases Meningioma and Schwannoma MRI
International Clinical Neuroscience Journal,
Vol. 10 No. 1 (2023),
15 January 2023
,
Page e4
Abstract
Background: We aimed to estimate the diagnostic accuracy of apparent diffusion coefficient values (ADC) and intra-tumoral susceptibility signals (ITSS) in differentiating meningiomas and schwannomas.
Methods: This retrospective study included 41 patients with 23 histopathologically proven meningiomas (20 patients with benign meningioma and 3 patients with high-grade meningioma) and 18 schwannomas. We calculated the mean ADC values and ADC ratio from ADC maps and intratumoral susceptibility signals (ITSS) in susceptibility-weighted imaging (SWI) for all patients. The quantitative variables were compared between the tumor groups using t test and the qualitative variables were compared between them using Chi-square test.
Results: In this study, the mean ADC value of meningiomas (0.86 ± 0.11×10-3 mm2/s, range 0.67-1.04) was lower than schwannomas (1.32 ± 0.16×10-3 mm2/s, range 1.10-1.65) with no overlap in the range of ADC values. The mean ADC ratio of schwannomas (2.0 ± 0.29, range 1.45- 2.58) was higher than meningiomas (1.24 ± 0.17, range 0.83-1.64) with some overlap. We found significant difference in mean ADC value and ADC ratio between meningiomas and schwannomas. The presence of intratumoral microhemorrhages (ITSS-H) in SWI was more suggestive of schwannomas and the presence of calcification was in favor of benign meningiomas. We did not find any significant difference in mean ADC value and ADC ratio between benign and high-grade meningiomas with considerable overlap in their range.
Conclusion: Additional magnetic resonance imaging findings such as ADC values and ITSS in SWI can help better pre-operative diagnosis of meningiomas and schwannomas, particularly in challenging patients.
- Meningiomas; Schwannomas; Apparent diffusion coefficient; Susceptibility-weighted imaging; intratumoral susceptibility signals.
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References
Alyamany M, Alshardan MM, Jamea AA, ElBakry N, Soualmi L, Orz Y. Meningioma consistency: correlation between magnetic resonance imaging characteristics, operative findings, and histopathological features. Asian J Neurosurg. 2018;13(2):324-8. doi: 10.4103/1793-5482.228515.
Abdel-Kerim A, Shehata M, El Sabaa B, Fadel S, Heikal A, Mazloum Y. Differentiation between benign and atypical cranial Meningiomas. Can ADC measurement help? MRI findings with hystopathologial correlation. Egypt J Radiol Nucl Med. 2018;49(1):172-5. doi: 10.1016/j.ejrnm.2017.10.004.
Zhang S, Chiang GC, Knapp JM, Zecca CM, He D, Ramakrishna R, et al. Grading meningiomas utilizing multiparametric MRI with inclusion of susceptibility weighted imaging and quantitative susceptibility mapping. J Neuroradiol. 2020;47(4):272-7. doi: 10.1016/j.neurad.2019.05.002.
Tsai YT, Hung KC, Shih YJ, Lim SW, Yang CC, Kuo YT, et al. Preoperative apparent diffusion coefficient values for differentiation between low and high grade meningiomas: an updated systematic review and meta-analysis. Diagnostics (Basel). 2022;12(3):630. doi: 10.3390/diagnostics12030630.
Salles D, Santino SF, Malinverni ACM, Stávale JN. Meningiomas: a review of general, histopathological, clinical and molecular characteristics. Pathol Res Pract. 2021;223:153476. doi: 10.1016/j.prp.2021.153476.
Huang RY, Bi WL, Griffith B, Kaufmann TJ, la Fougère C, Schmidt NO, et al. Imaging and diagnostic advances for intracranial meningiomas. Neuro Oncol. 2019;21(Suppl 1):i44-i61. doi: 10.1093/neuonc/noy143.
Saravanan K, Parthasarathy EA, Farook AS, Sridharan P, Gopalakrishnan, Anand R. Role of susceptibility weighted imaging in cerebellopontine angle schwannoma vs meningioma. International Journal of Contemporary Medicine, Surgery and Radiology. 2018;3(2):B20-B23.
Khaled M, Moghazy K, Elsaadany W, Eissa L. Additional diagnostic role of MRI spectroscopy, diffusion and susceptibility imaging in differentiation of CPA masses: our experience with emphasis on schwannomas and meningiomas. Egypt J Radiol Nucl Med. 2020;51(1):137. doi: 10.1186/s43055-020-00256-5.
Pavlisa G, Rados M, Pazanin L, Padovan RS, Ozretic D, Pavlisa G. Characteristics of typical and atypical meningiomas on ADC maps with respect to schwannomas. Clin Imaging. 2008;32(1):22-7. doi: 10.1016/j.clinimag.2007.07.007.
Zikou A, Alexiou GA, Goussia A, Kosta P, Xydis V, Voulgaris S, et al. The role of diffusion tensor imaging and dynamic susceptibility perfusion MRI in the evaluation of meningioma grade and subtype. Clin Neurol Neurosurg. 2016;146:109- 15. doi: 10.1016/j.clineuro.2016.05.005.
Khedr SA, Hassaan MA, Refaat A. The diagnostic value of diffusion weighted imaging in patients with meningioma. Egypt J Radiol Nucl Med. 2012;43(2):249-56. doi: 10.1016/j. ejrnm.2012.01.003.
Shiroishi MS, Cen SY, Tamrazi B, D’Amore F, Lerner A, King KS, et al. Predicting meningioma consistency on preoperative neuroimaging studies. Neurosurg Clin N Am. 2016;27(2):145- 54. doi: 10.1016/j.nec.2015.11.007.
Miyoshi K, Wada T, Uwano I, Sasaki M, Saura H, Fujiwara S, et al. Predicting the consistency of intracranial meningiomas using apparent diffusion coefficient maps derived from preoperative diffusion-weighted imaging. J Neurosurg. 2020;135(3):969-76. doi: 10.3171/2020.6.jns20740.
Bozdag M, Er A. Relation of susceptibility-weighted imaging findings with histological grade in intracranial meningiomas. Ann Med Res. 2021;28(4):806-11.
Kasuya H, Kubo O, Tanaka M, Amano K, Kato K, Hori T. Clinical and radiological features related to the growth potential of meningioma. Neurosurg Rev. 2006;29(4):293-7. doi: 10.1007/s10143-006-0039-3.
Kane AJ, Sughrue ME, Rutkowski MJ, Shangari G, Fang S, McDermott MW, et al. Anatomic location is a risk factor for atypical and malignant meningiomas. Cancer. 2011;117(6):1272-8. doi: 10.1002/cncr.25591.
Mishra A, Thomas B, Kapilamoorthy TR. Susceptibility weighted imaging - a problem-solving tool in differentiation of cerebellopontine angle schwannomas and meningiomas. Neuroradiol J. 2017;30(3):253-8. doi: 10.1177/1971400916689804.
Sanverdi SE, Ozgen B, Oguz KK, Mut M, Dolgun A, Soylemezoglu F, et al. Is diffusion-weighted imaging useful in grading and differentiating histopathological subtypes of meningiomas? Eur J Radiol. 2012;81(9):2389-95. doi: 10.1016/j.ejrad.2011.06.031.
Santelli L, Ramondo G, Della Puppa A, Ermani M, Scienza R, d’Avella D, et al. Diffusion-weighted imaging does not predict histological grading in meningiomas. Acta Neurochir (Wien). 2010;152(8):1315-9. doi: 10.1007/s00701-010-0657-y.
Meyer HJ, Wienke A, Surov A. ADC values of benign and high grade meningiomas and associations with tumor cellularity and proliferation - a systematic review and meta-analysis. J Neurol Sci. 2020;415:116975. doi: 10.1016/j. jns.2020.116975.
Hakyemez B, Yildirim N, Gokalp G, Erdogan C, Parlak M. The contribution of diffusion-weighted MR imaging to distinguishing typical from atypical meningiomas. Neuroradiology. 2006;48(8):513-20. doi: 10.1007/s00234- 006-0094-z.
Tang Y, Dundamadappa SK, Thangasamy S, Flood T, Moser R, Smith T, et al. Correlation of apparent diffusion coefficient with Ki-67 proliferation index in grading meningioma. AJR Am J Roentgenol. 2014;202(6):1303-8. doi: 10.2214/ ajr.13.11637.
Toh CH, Castillo M, Wong AM, Wei KC, Wong HF, Ng SH, et al. Differentiation between classic and atypical meningiomas with use of diffusion tensor imaging. AJNR Am J Neuroradiol. 2008;29(9):1630-5. doi: 10.3174/ajnr.A1170.
Yin B, Liu L, Zhang BY, Li YX, Li Y, Geng DY. Correlating apparent diffusion coefficients with histopathologic findings on meningiomas. Eur J Radiol. 2012;81(12):4050-6. doi: 10.1016/j.ejrad.2012.06.002.
Surov A, Gottschling S, Mawrin C, Prell J, Spielmann RP, Wienke A, et al. Diffusion-weighted imaging in meningioma: prediction of tumor grade and association with histopathological parameters. Transl Oncol. 2015;8(6):517- 23. doi: 10.1016/j.tranon.2015.11.012.
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