Hao Yu1,2, Xinrui Wen3, Pingping Wu4, Yueqin Chen1, Tianyu Zou5, Xianlong Wang2, Shanshan Jiang2,6, Jinyuan Zhou6, Zhibo Wen7. 1. Department of Radiology, Affiliated Hospital of Jining Medical University, Jining Medical University, Guhuai Road No. 89, Rencheng District, Jining, 272029, Shandong, China. 2. Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No. 253, Haizhu District, Guangzhou, 510282, Guangdong, China. 3. Department of Neurology, Zhujiang Hospital, Southern Medical University, Gongye Road M No. 253, Haizhu District, Guangzhou, 510282, Guangdong, China. 4. Department of Clinical Laboratory, Jining NO. 1 People's Hospital, 6 Jiankang Road, Jining, 272011, China. 5. Department of Radiology, Weihai Municipal Hospital, Heping Road M No.70, Weihai, 264200, Shandong, China. 6. Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, 600N. Wolfe Street, Park 336, Baltimore, MD, 21287, USA. 7. Department of Radiology, Zhujiang Hospital, Southern Medical University, Gongye Road M No. 253, Haizhu District, Guangzhou, 510282, Guangdong, China. zhibowen@163.com.
Abstract
OBJECTIVES: To determine the utility of the amide proton transfer-weighted MR imaging in differentiating the WHO grade and predict proliferative activity of meningioma. METHODS: Fifty-three patients with WHO grade I meningiomas and 26 patients with WHO grade II meningiomas underwent conventional and APT-weighted sequences on a 3.0 Tesla MR before clinical intervention. The APT-weighted (APTw) parameters in the solid tumor region were obtained and compared between two grades using the t test; the receiver operating characteristic (ROC) curve was used to assess the best parameter for predicting the grade of meningiomas. Pearson's correlation coefficient was calculated between the APTwmax and Ki-67 labeling index in meningiomas. RESULTS: The APTwmax and APTwmean values were not significantly different between WHO grade I and grade II meningiomas (p = 0.103 and p = 0.318). The APTwmin value was higher and the APTwmax-min value was lower in WHO grade II meningiomas than in WHO grade I tumors (p = 0.027 and p = 0.019). But the APTwmin was higher and the APTwmax-min was lower in microcystic meningiomas than in WHO grade II meningiomas (p = 0.001 and p = 0.006). The APTwmin combined with APTwmax-min showed the best diagnostic performance in predicting the grade of meningiomas with an AUC of 0.772. The APTwmax value was positively correlated with Ki-67 labeling index (r = 0.817, p < 0.001) in meningiomas; the regression equation for the Ki-67 labeling index (%) (Y) and APTwmax (%) (X) was Y = 4.9 × X - 12.4 (R2 = 0.667, p < 0.001). CONCLUSION: As a noninvasive imaging method, the ability of APTw-MR imaging in differentiating the grade of meningiomas is limited, but the technology can be used to predict the proliferative activity of meningioma. KEY POINTS: • The APTw min value was higher and the APTw max-min value was lower in WHO grade II meningioma than in grade I tumors. • The APTw min value was higher and the APTw max-min value was lower in microcystic meningiomas than in WHO grade II meningiomas. • The APTw max value was positively correlated with meningioma proliferation index.
OBJECTIVES: To determine the utility of the amide proton transfer-weighted MR imaging in differentiating the WHO grade and predict proliferative activity of meningioma. METHODS: Fifty-three patients with WHO grade I meningiomas and 26 patients with WHO grade II meningiomas underwent conventional and APT-weighted sequences on a 3.0 Tesla MR before clinical intervention. The APT-weighted (APTw) parameters in the solid tumor region were obtained and compared between two grades using the t test; the receiver operating characteristic (ROC) curve was used to assess the best parameter for predicting the grade of meningiomas. Pearson's correlation coefficient was calculated between the APTwmax and Ki-67 labeling index in meningiomas. RESULTS: The APTwmax and APTwmean values were not significantly different between WHO grade I and grade II meningiomas (p = 0.103 and p = 0.318). The APTwmin value was higher and the APTwmax-min value was lower in WHO grade II meningiomas than in WHO grade I tumors (p = 0.027 and p = 0.019). But the APTwmin was higher and the APTwmax-min was lower in microcystic meningiomas than in WHO grade II meningiomas (p = 0.001 and p = 0.006). The APTwmin combined with APTwmax-min showed the best diagnostic performance in predicting the grade of meningiomas with an AUC of 0.772. The APTwmax value was positively correlated with Ki-67 labeling index (r = 0.817, p < 0.001) in meningiomas; the regression equation for the Ki-67 labeling index (%) (Y) and APTwmax (%) (X) was Y = 4.9 × X - 12.4 (R2 = 0.667, p < 0.001). CONCLUSION: As a noninvasive imaging method, the ability of APTw-MR imaging in differentiating the grade of meningiomas is limited, but the technology can be used to predict the proliferative activity of meningioma. KEY POINTS: • The APTw min value was higher and the APTw max-min value was lower in WHO grade II meningioma than in grade I tumors. • The APTw min value was higher and the APTw max-min value was lower in microcystic meningiomas than in WHO grade II meningiomas. • The APTw max value was positively correlated with meningioma proliferation index.
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