Title: Accuracy of Perfusion MRI in Differentiating Benign From Atypical and Malignant Meningiomas
Authors: Dr Rani Ann Joseph, Dr Manoj T Pillai, Dr Anusha Lingaiah Pujar
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.117
Abstract
Aim: To study the diagnostic accuracy of Perfusion Magnetic Resonance Imaging in differentiating benign from atypical and malignant meningiomas and comparing with histopathology as the gold standard.
Methodology: 100patients with intracranial meningiomas referred to the Department of Radiodiagnosis, for imaging were included in the study after applying inclusion and exclusion criteria. MR imaging of the head with Dynamic Susceptibility Contrast Perfusion Weighted Imaging was done. Maximal relative cerebral blood volume in the tumor – r CBV(t) and in the peritumoral tissue – rCBV(p) was calculated. Cut-off was obtained after drawing ROC rCBV(t) and rCBV(p).
Results and Interpretations: Perfusion weighted imaging in the peritumoral tissue can reliably differentiate between benign and atypical meningiomas. Using rCBV(p) as the diagnostic test, present study shows a sensitivity of 90.48% and specificity of 98.73% (p<0.0001).
Keywords- MRI, rCBV(p), rMTE(p), differentiation of typical and atypical meningiomas, perfusion.
References
1. Mahesh V Jayaraman, Jerrold L Boxerman. Adult brain tumors. In: Scott W Atlas. Magnetic Resonance Imaging of the brain and spine. 4th edition. Philadelphia: Lippincott Williams &Wilkins ; 2009.
2. Markus JRiemenschneider, Arie Perry, Guido Reifenberger. Histological classification and molecular genetics of meningiomas. Lancet Neurol 2006; 5: 1045–54. Available from - www.sciencedirect.com/science/article/pii/S1474442206706251
3. Walker C, Baborie A, Crooks D, et al. Biology, genetics and imaging of glial cell tumours. Br J Radiol.2011;84 Spec No 2:S90-106.
4. Jain RK, di Tomaso E, Duda DG, et al. Angiogenesis in brain tumours. Nat Rev Neurosci. 2007; 8:610-622.
5. S. Chedia, M. Gagua, N. Kbilashvili; Kutaisi/GE. Differentiation between benign and malignant meningiomas using diffusion and perfusion MR imaging. 10.1594/ecr2011/B-212. Available from www.myESR.com