L Lin1, Y Xue2, Q Duan2, X Chen3, H Chen4, R Jiang2, T Zhong2, G Xu5, D Geng6, J Zhang7. 1. Department of Radiology, Huashan Hospital, Fudan University, No.12 Wulumuqi Road (Middle), Jingan District, Shanghai, China. 2. Department of Radiology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, Fujian, China. 3. Department of Radiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, 240 Fuma Road, Jinan District, Fuzhou, Fujian, China. 4. Department of Pathology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, Fujian, China. 5. Department of Management Science, University of Miami, Coral Gables, FL, USA. 6. Department of Radiology, Huashan Hospital, Fudan University, No.12 Wulumuqi Road (Middle), Jingan District, Shanghai, China. Electronic address: gengdy@163.com. 7. Department of Radiology, Huashan Hospital, Fudan University, No.12 Wulumuqi Road (Middle), Jingan District, Shanghai, China. Electronic address: zhj81828@163.com.
Abstract
AIM: To prospectively evaluate and compare the potential of various diffusion metrics obtained from mono-exponential model (MEM), bi-exponential model (BEM), and stretched exponential model (SEM)-based diffusion-weighted imaging (DWI) in the grading of meningiomas. MATERIAL AND METHODS: Consecutive 93 patients with histopathologically confirmed meningiomas received DWI of multiple b-values. Apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), water molecular diffusion heterogeneity index (alpha), and distributed diffusion coefficient (DDC) were calculated and compared between low-grade and high-grade meningiomas. Receiver operating characteristic and multivariable stepwise logistic regression analyses were performed to evaluate the diagnostic performance of different parameters. RESULTS: The mean and normalised ADC, D, f, and DDC values were significantly lower in high-grade meningiomas than those in low-grade meningiomas (all p<0.05). The AUCs of D and DDC were significantly higher than that of f in the differentiation (all p<0.05). D was the only variable that could be used to independently differentiate high-grade and low-grade meningiomas (p<0.001). CONCLUSION: Different models of DWI, including MEM, BEM, and SEM, are useful in the differentiating high-grade and low-grade meningiomas; however, D obtained from BEM is the most promising diffusion parameter for predicting the grade of meningiomas.
AIM: To prospectively evaluate and compare the potential of various diffusion metrics obtained from mono-exponential model (MEM), bi-exponential model (BEM), and stretched exponential model (SEM)-based diffusion-weighted imaging (DWI) in the grading of meningiomas. MATERIAL AND METHODS: Consecutive 93 patients with histopathologically confirmed meningiomas received DWI of multiple b-values. Apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), water molecular diffusion heterogeneity index (alpha), and distributed diffusion coefficient (DDC) were calculated and compared between low-grade and high-grade meningiomas. Receiver operating characteristic and multivariable stepwise logistic regression analyses were performed to evaluate the diagnostic performance of different parameters. RESULTS: The mean and normalised ADC, D, f, and DDC values were significantly lower in high-grade meningiomas than those in low-grade meningiomas (all p<0.05). The AUCs of D and DDC were significantly higher than that of f in the differentiation (all p<0.05). D was the only variable that could be used to independently differentiate high-grade and low-grade meningiomas (p<0.001). CONCLUSION: Different models of DWI, including MEM, BEM, and SEM, are useful in the differentiating high-grade and low-grade meningiomas; however, D obtained from BEM is the most promising diffusion parameter for predicting the grade of meningiomas.