Distinguishing transitional meningioma from atypical meningioma based on quantitative parameters of apparent diffusion coefficient

CHEN Xu; WANG Linkun; SHEN Yu; BAI Yan; WANG Meiyun

Abstract：Objective To evaluate the efficacy of histogram parameters of the apparent diffusion coefficient(ADC)in preoperative discrimination between transitional meningioma(TM)and atypical meningioma(AM).Methods A retrospective analysis was conducted on patient data verified by histopathological assessment,including 66 TM cases and 30 AM cases.3DSlicer software was employed to delineate the region of interest(ROI)bordering the tumor on the tumor's ADC images through a double-blind approach,which omitted regions of necrosis,cystic alteration,and hemorrhage within the ROI.Subsequently,a grayscale histogram was generated from the grayscale values within the ROI and the receiver operating characteristic(ROC)curves were generated to calculate the corresponding area under the curve(AUC).Correlations between ADC histogram parameters and pathologic indices such as the Ki-67 proliferation index,progesterone receptor(PR),epithelial membrane antigen(EMA),and S-100 protein were assessed.Results The parameters of variance,skewness,kurtosis,and maximum in the TM group were found to be statistically significantly higher than those in the AM group(P<0.05).Furthermore,the parameters of variance,skewness,kurtosis,maximum,and Perc.90 demonstrated negative correlations with the Ki-67 proliferation index.Significant differences were observed in the variance,minimum,and Perc.10 between PR-positive and PR-negative meningiomas(P<0.05).Conclusion The histogram analysis of ADC is instrumental in facilitating the preoperative differentiation between TM and AM,and the derived parameters can predict Ki-67 levels and PR expression.