Utility of multiparametric pre-operative magnetic resonance imaging in differentiation of chordoid meningioma from the other histopathological subtypes of meningioma—a retrospective study

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 meni...

Full description

Saved in:
Bibliographic Details
Published in:Neuroradiology 2022-02, Vol.64 (2), p.253-264
Main Authors: Peer, Sameer, Saini, Jitender, Prasad, Chandrajit, Kulanthaivelu, Karthik, Sadashiva, Nishanth, Nandeesh, Bevinahalli N, Uppar, Alok Mohan, Rao, Shilpa
Format: Article
Language:English
Subjects:
Anisotropy
Brain cancer
Brain tumors
Diagnostic Neuroradiology
Diffusion Magnetic Resonance Imaging
Edema
Histology
Humans
Imaging
Magnetic Resonance Imaging
Medical imaging
Medicine
Medicine & Public Health
Meningeal Neoplasms - diagnostic imaging
Meningeal Neoplasms - surgery
Meningioma
Meningioma - diagnostic imaging
Meningioma - surgery
Neuroimaging
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Parenchyma
Radiology
Recovery (Medical)
Resonance
Retrospective Studies
Sensitivity
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-021-02690-2