Sameer Peer1, Jitender Saini2, Chandrajit Prasad1, Karthik Kulanthaivelu1, Nishanth Sadashiva3, Bevinahalli N Nandeesh4, Alok Mohan Uppar3, Shilpa Rao4. 1. Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, 560029, India. 2. Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, 560029, India. jsaini76@gmail.com. 3. Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, 560029, India. 4. Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, 560029, India.
Abstract
PURPOSE: To determine the magnetic resonance imaging (MRI) features which could pre-operatively differentiate chordoid meningioma (CM) from other histopathological subtypes of meningioma. METHODS: Retrospective analysis of pre-operative MRI of cases with histopathologically confirmed diagnosis of meningioma during the last 5 years at our institute was done. T1W, T2W, FLAIR sequences, and post-contrast enhancement were evaluated on a qualitative scale. Normalized ADC ratios (nADCR) and normalized fractional anisotropy ratios (nFAR) were derived. The intratumoral susceptibility score (ITSS), presence of sunburst pattern of vasculature, bone changes, tumour-parenchyma interface, and oedema-to-tumour ratio were also determined. RESULTS: A total of 81 lesions were analyzed out of which 15 were CM. CM showed a higher relative contrast enhancement as compared to all other subtypes except for angiomatous and microcystic meningioma. Relative signal intensity on FLAIR could differentiate CM from transitional meningioma. nFAR was found to be significantly higher in fibroblastic meningioma and significantly lower in microcystic meningiomas as compared to CM. Anaplastic meningiomas were remarkable for bone changes and an ill-defined tumour-brain interface in significantly higher proportion of cases as compared to CM. nADCR > 1.5 was found to be an independent predictor of CM with a sensitivity of 84.6%, specificity of 89.8%, positive predictive value of 64.7%, and negative predictive value of 96.4%. CONCLUSION: Routine pre-operative MRI may be able to differentiate CM from other meningioma subtypes and a cut-off value of greater than 1.5 for nADCR could be predictive of > 50% chordoid histology of meningioma with a high sensitivity, specificity, and negative predictive value.
PURPOSE: To determine the magnetic resonance imaging (MRI) features which could pre-operatively differentiate chordoid meningioma (CM) from other histopathological subtypes of meningioma. METHODS: Retrospective analysis of pre-operative MRI of cases with histopathologically confirmed diagnosis of meningioma during the last 5 years at our institute was done. T1W, T2W, FLAIR sequences, and post-contrast enhancement were evaluated on a qualitative scale. Normalized ADC ratios (nADCR) and normalized fractional anisotropy ratios (nFAR) were derived. The intratumoral susceptibility score (ITSS), presence of sunburst pattern of vasculature, bone changes, tumour-parenchyma interface, and oedema-to-tumour ratio were also determined. RESULTS: A total of 81 lesions were analyzed out of which 15 were CM. CM showed a higher relative contrast enhancement as compared to all other subtypes except for angiomatous and microcystic meningioma. Relative signal intensity on FLAIR could differentiate CM from transitional meningioma. nFAR was found to be significantly higher in fibroblastic meningioma and significantly lower in microcystic meningiomas as compared to CM. Anaplastic meningiomas were remarkable for bone changes and an ill-defined tumour-brain interface in significantly higher proportion of cases as compared to CM. nADCR > 1.5 was found to be an independent predictor of CM with a sensitivity of 84.6%, specificity of 89.8%, positive predictive value of 64.7%, and negative predictive value of 96.4%. CONCLUSION: Routine pre-operative MRI may be able to differentiate CM from other meningioma subtypes and a cut-off value of greater than 1.5 for nADCR could be predictive of > 50% chordoid histology of meningioma with a high sensitivity, specificity, and negative predictive value.
Authors: J D Baal; W C Chen; D A Solomon; J S Pai; C-H Lucas; J H Hara; N A Oberheim Bush; M W McDermott; D R Raleigh; J E Villanueva-Meyer Journal: AJNR Am J Neuroradiol Date: 2019-02-28 Impact factor: 3.825
Authors: J B Pond; T G Morgan; K J Hatanpaa; Z F Yetkin; B E Mickey; D B Mendelsohn Journal: AJNR Am J Neuroradiol Date: 2015-04-16 Impact factor: 3.825
Authors: Thibaud P Coroller; Wenya Linda Bi; Elizabeth Huynh; Malak Abedalthagafi; Ayal A Aizer; Noah F Greenwald; Chintan Parmar; Vivek Narayan; Winona W Wu; Samuel Miranda de Moura; Saksham Gupta; Rameen Beroukhim; Patrick Y Wen; Ossama Al-Mefty; Ian F Dunn; Sandro Santagata; Brian M Alexander; Raymond Y Huang; Hugo J W L Aerts Journal: PLoS One Date: 2017-11-16 Impact factor: 3.240