Amide Proton Transfer Weighted MR Imaging for Predicting Meningioma Stiffness: A Feasibility Study

J Magn Reson Imaging. 2022 Aug 5. doi: 10.1002/jmri.28379. Online ahead of print.

ABSTRACT

BACKGROUND: Stiffness of meningioma is an important factor affecting the surgical resection and the prognosis of patients.

PURPOSE: To examine the feasibility of APTw-magnetic resonance imaging (MRI) in evaluating meningioma stiffness.

STUDY TYPE: Retrospective.

POPULATION: Seventy-one patient with meningiomas, 39 were male and 32 were female; the mean age was 51 ± 10 years.

FIELD STRENGTH/SEQUENCE: 3.0T; Turbo-spin-echo T₁ -weighted and Gd-T₁ -weighted sequence; Turbo-spin-echo T₂ -weighted sequence; 2D fat-suppressed, turbo-spin-echo APTw pulse sequence.

ASSESSMENT: The T₁ WI signal intensity score, T₂ WI signal intensity score, APTw_min , APTw_max , and APTw_mean values were compared between soft, medium stiff and stiff meningiomas or non-stiff meningiomas and stiff meningiomas group.

STATISTICAL TESTS: Chi-square test, one-way ANOVA analysis, independent-samples t-test, intra-class correlation coefficient, rank-sum test, receiver operating characteristic curve analysis. P < 0.05 was considered statistically significant in all tests.

RESULTS: APTw_min and APTw_mean in the stiff group were significantly lower than that in the non-stiff group (2.79% ± 0.42% vs. 1.90% ± 0.60% and 3.20% ± 0.31% vs. 2.55% ± 0.61%). APTw_min and APTw_mean in the stiff group were significantly lower than that in the medium stiff and soft groups (1.90% ± 0.60% vs. 2.69% ± 0.40% and 3.12% ± 0.32%, 2.55% ± 0.61% vs. 3.17% ± 0.33% and 3.39% ± 0.18%), APTw_min in the medium stiff group was significantly lower than in the soft group, there was no significant difference in APTw_mean between the medium stiff and soft groups (P = 0.190). APTw_min showed the best diagnostic performance for evaluating meningioma stiffness with an area under the curve of 0.913, when the APTw_min was lower than 2.4%, the meningioma was defined as a stiff tumor, the sensitivity, specificity, and accuracy were 87.1%, 87.5%, and 85.9%, respectively.

DATA CONCLUSION: APTw-MRI could be used to evaluate meningioma stiffness, with APTw_min having the best evaluative efficiency.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 1.

PMID:35932167 | DOI:10.1002/jmri.28379