Abstract

BackgroundOur purpose was to evaluate the application of volumetric histogram parameters obtained from conventional MRI and apparent diffusion coefficient (ADC) images for grading the meningioma tumors.ResultsTumor volumetric histograms of preoperative MRI images from 45 patients with the diagnosis of meningioma at different grades were analyzed to find the histogram parameters. Kruskal-Wallis statistical test was used for comparison between the parameters obtained from different grades. Multi-parametric regression analysis was used to find the model and parameters with high predictive value for the classification of meningioma. Mode; standard deviation on post-contrast T1WI, T2-FLAIR, and ADC images; kurtosis on post-contrast T1WI and T2-FLAIR images; mean and several percentile values on ADC; and post-contrast T1WI images showed significant differences among different tumor grades (P < 0.05). The multi-parametric linear regression showed that the ADC histogram parameters model had a higher predictive value, with cutoff values of 0.212 (sensitivity = 79.6%, specificity = 84.3%) and 0.180 (sensitivity = 70.9%, specificity = 80.8%) for differentiating the grade I from II, and grade II from III, respectively.ConclusionsThe multi-parametric model of volumetric histogram parameters in some of the conventional MRI series (i.e., post-contrast T1WI and T2-FLAIR images) along with the ADC images are appropriate for predicting the meningioma tumors’ grade.

Highlights

  • Our purpose was to evaluate the application of volumetric histogram parameters obtained from conventional Magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) images for grading the meningioma tumors

  • The histogram changes with tumor grade are obvious in this figure, in such a way that, histogram mode, median, and mean values of ADC images differ significantly at different tumor grades (P < 0.03)

  • None of the tumor histogram parameters in pre-contrast T1-weighted and T2-weighted images showed any significant differences between different meningioma tumor grades (P > 0.2), except in the range in T2WI (P < 0.04)

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Summary

Introduction

Our purpose was to evaluate the application of volumetric histogram parameters obtained from conventional MRI and apparent diffusion coefficient (ADC) images for grading the meningioma tumors. Various pulse sequences like “spine echo” and “spin echo-echo planar” are usually applied during MRI procedures to obtain T1-weighted, T2-weighted, and diffusion-weighted images (DWI) for illustrating CNS tumors. Quantified images obtained from DWI, namely apparent diffusion coefficient (ADC), can differentiate low-grade from highgrade meningiomas [3,4,5,6,7] with a sensitivity of 72.9% and specificity of 73.1% [6]. There is a study that reported the volumetric histogram analysis of ADC values for differentiating the low-grade tumors from moderate and high-grade ones [3]

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