Bio Joo1, Kyunghwa Han2, Yoon Seong Choi2, Seung-Koo Lee2, Sung Soo Ahn3,4, Jong Hee Chang5, Seok-Gu Kang5, Se Hoon Kim6, Jinyuan Zhou7. 1. Department of Radiology, The Armed Forces Capital Hospital, Seongnam, Gyeonggi-do, Korea. 2. Department of Radiology and Research Institute of Radiological Science, College of Medicine, Yonsei University College of Medicine, Seoul, Korea. 3. Department of Radiology and Research Institute of Radiological Science, College of Medicine, Yonsei University College of Medicine, Seoul, Korea. SUNGSOO@yuhs.ac. 4. Department of Radiology, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea. SUNGSOO@yuhs.ac. 5. Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea. 6. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea. 7. Division of MRI Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
PURPOSE: To investigate the difference in amide proton transfer (APT)-weighted signals between benign and atypical meningiomas and determine the value of APT imaging for differentiating the two. METHODS: Fifty-seven patients with pathologically diagnosed meningiomas (benign, 44; atypical, 13), who underwent preoperative MRI with APT imaging between December 2014 and August 2016 were included. We compared normalised magnetisation transfer ratio asymmetry (nMTR asym ) values between benign and atypical meningiomas on APT-weighted images. Conventional MRI features were qualitatively assessed. Both imaging features were evaluated by multivariable logistic regression analysis. The discriminative value of MRI with and without nMTR asym was evaluated. RESULTS: The nMTR asym of atypical meningiomas was significantly greater than that of benign meningiomas (2.46% vs. 1.67%; P < 0.001). In conventional MR images, benign and atypical meningiomas exhibited significant differences in maximum tumour diameter, non-skull base location, and heterogeneous enhancement. On multivariable logistic regression analysis, high nMTR asym was an independent predictor of atypical meningiomas (adjusted OR, 11.227; P = 0.014). The diagnostic performance of MRI improved with nMTR asym for predicting atypical meningiomas. CONCLUSION: Atypical meningiomas exhibited significantly higher APT-weighted signal intensities than benign meningiomas. The discriminative value of conventional MRI improved significantly when combined with APT imaging for diagnosis of atypical meningioma. KEY POINTS: • APT imaging is useful for differentiating between atypical and benign meningiomas. • Atypical meningiomas exhibited high APT-weighted signal intensity than benign meningiomas. • The diagnostic performance of MRI improved with nMTR asym for predicting atypical meningiomas.
PURPOSE: To investigate the difference in amide proton transfer (APT)-weighted signals between benign and atypical meningiomas and determine the value of APT imaging for differentiating the two. METHODS: Fifty-seven patients with pathologically diagnosed meningiomas (benign, 44; atypical, 13), who underwent preoperative MRI with APT imaging between December 2014 and August 2016 were included. We compared normalised magnetisation transfer ratio asymmetry (nMTR asym ) values between benign and atypical meningiomas on APT-weighted images. Conventional MRI features were qualitatively assessed. Both imaging features were evaluated by multivariable logistic regression analysis. The discriminative value of MRI with and without nMTR asym was evaluated. RESULTS: The nMTR asym of atypical meningiomas was significantly greater than that of benign meningiomas (2.46% vs. 1.67%; P < 0.001). In conventional MR images, benign and atypical meningiomas exhibited significant differences in maximum tumour diameter, non-skull base location, and heterogeneous enhancement. On multivariable logistic regression analysis, high nMTR asym was an independent predictor of atypical meningiomas (adjusted OR, 11.227; P = 0.014). The diagnostic performance of MRI improved with nMTR asym for predicting atypical meningiomas. CONCLUSION:Atypical meningiomas exhibited significantly higher APT-weighted signal intensities than benign meningiomas. The discriminative value of conventional MRI improved significantly when combined with APT imaging for diagnosis of atypical meningioma. KEY POINTS: • APT imaging is useful for differentiating between atypical and benign meningiomas. • Atypical meningiomas exhibited high APT-weighted signal intensity than benign meningiomas. • The diagnostic performance of MRI improved with nMTR asym for predicting atypical meningiomas.
Entities:
Keywords:
Amide proton transfer (APT); Chemical exchange saturation transfer (CEST); Magnetic resonance imaging; Meningioma; Tumour grading
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