Ching-Chung Ko1, Tai-Yuan Chen2, Sher-Wei Lim3, Yu-Ting Kuo4, Te-Chang Wu5, Jeon-Hor Chen6. 1. Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan, Taiwan. Electronic address: crazyboy0729@gmail.com. 2. Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan, Taiwan; Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, Taiwan. 3. Department of Neurosurgery, Chi-Mei Medical Center, Chiali, Tainan, Taiwan; Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan. 4. Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan, Taiwan; Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 5. Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan, Taiwan; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan. 6. Department of Radiology, E-DA Hospital, E-DA Cancer Hospital, I-Shou University, Kaohsiung, Taiwan; Center for Functional Onco-Imaging of Radiological Sciences, School of Medicine, University of California, Irvine, California, USA.
Abstract
BACKGROUND: Parasagittal and parafalcine (PSPF) meningiomas recur more frequently than other intracranial meningiomas owing to the difficulty in achieving gross total resection. The present study investigated the preoperative magnetic resonance imaging (MRI) features for the prediction of progression/recurrence (P/R) in benign PSPF meningiomas with an emphasis on the apparent diffusion coefficient (ADC) values. METHODS: We retrospectively investigated the preoperative MRI features for the prediction of P/R in benign (World Health Organization grade I) PSPF meningiomas. Only patients who had undergone preoperative and postoperative MRI follow-up studies for ≥1 year were included. From October 2006 to December 2015, 48 patients with a diagnosis of benign PSPF meningioma were included (median follow-up period, 42.5 months). Of these 48 patients, 12 (25%) developed P/R (median time to P/R, 23 months). RESULTS: PSPF meningiomas in male patients, subtotal resection, large tumor diameter, high diffusion-weighted imaging signal, and lower ADC values or ratios were significantly associated with P/R (P < 0.05). The cutoff points of the ADC value and ADC ratio for the prediction of P/R were 0.83 × 10-3 mm2/second and 0.99, with an area under the curve of 0.82 and 0.83, respectively (P = 0.001). On multivariate Cox proportional hazards analysis, male sex and low ADC values (<0.83 × 10-3 mm2/second) were high-risk factors for P/R, with a hazard ratio of 12.37 and 30.2, respectively (P < 0.05). Kaplan-Meier analysis showed that lower ADC values and ratios predicted for significantly shorter progression-free survival (P < 0.05). CONCLUSIONS: The preoperative ADC values and ratios for the prediction of P/R offer additional valuable information for the treatment planning for PSPF meningiomas.
BACKGROUND:Parasagittal and parafalcine (PSPF) meningiomas recur more frequently than other intracranial meningiomas owing to the difficulty in achieving gross total resection. The present study investigated the preoperative magnetic resonance imaging (MRI) features for the prediction of progression/recurrence (P/R) in benign PSPF meningiomas with an emphasis on the apparent diffusion coefficient (ADC) values. METHODS: We retrospectively investigated the preoperative MRI features for the prediction of P/R in benign (World Health Organization grade I) PSPF meningiomas. Only patients who had undergone preoperative and postoperative MRI follow-up studies for ≥1 year were included. From October 2006 to December 2015, 48 patients with a diagnosis of benign PSPF meningioma were included (median follow-up period, 42.5 months). Of these 48 patients, 12 (25%) developed P/R (median time to P/R, 23 months). RESULTS:PSPF meningiomas in male patients, subtotal resection, large tumor diameter, high diffusion-weighted imaging signal, and lower ADC values or ratios were significantly associated with P/R (P < 0.05). The cutoff points of the ADC value and ADC ratio for the prediction of P/R were 0.83 × 10-3 mm2/second and 0.99, with an area under the curve of 0.82 and 0.83, respectively (P = 0.001). On multivariate Cox proportional hazards analysis, male sex and low ADC values (<0.83 × 10-3 mm2/second) were high-risk factors for P/R, with a hazard ratio of 12.37 and 30.2, respectively (P < 0.05). Kaplan-Meier analysis showed that lower ADC values and ratios predicted for significantly shorter progression-free survival (P < 0.05). CONCLUSIONS: The preoperative ADC values and ratios for the prediction of P/R offer additional valuable information for the treatment planning for PSPF meningiomas.