Grading meningiomas using mono-exponential, bi-exponential and stretched exponential model-based diffusion-weighted MR imaging. Issue 8 (August 2019)

• Record Type: Journal Article
• Authors: Lin, L.; Xue, Y.; Duan, Q.; Chen, X.; Chen, H.; Jiang, R.; Zhong, T.; Xu, G.; Geng, D.; Zhang, J.
• Is Part Of: Clinical radiology. Volume 74:Issue 8(2019)
• Page Start: 651.e15
• Page End: 651.e23
• Publication Date: 2019-08
• Subjects: Medical radiology -- Periodicals; Radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiology -- Periodicals; Societies, Medical -- Periodicals; Medical radiology; Radiotherapy; Electronic journals; Periodicals; 616.0757
• DOI: 10.1016/j.crad.2019.04.007
• Languages: English
• ISSNs: 0009-9260

Abstract

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. Highlights: DWI-derived parameters from different models can help to grade meningiomas. D and DDC are superior to f in distinguishing low-grade from high-grade meningiomas. D derived from BEM is the strongest independent factor for predicting the grade of meningiomas.