MRI morphological features combined with apparent diffusion coefficient can predict brain invasion in meningioma

Abstract

Objectives

Accurately predicting meningioma brain invasion preoperatively helps to select the appropriate surgical approach and predict prognosis, but there are few imaging features that are sufficient for discriminating it alone. We investigate the joint MR imaging features and apparent diffusion coefficient (ADC) to predict the risk of brain invasion of meningiomas preoperatively.

Methods

In this retrospective study, 143 patients (invasion group:51, non-invasion group: 92) diagnosed with meningioma by histopathology were included. The maximum (ADC_max), minimum (ADC_min) and mean (ADC_mean) values of ADC and the mean ADC values of a comparative ROI in the normal appearing white matter (ADC_NAWM) were calculated. Differences between clinical features, MRI morphological features, and all ADC values were assessed by Pearson's chi-square test and Kruskal-Wallis rank-sum test. Stepwise logistic regression analysis was used to select the optimal features and construct a prediction model. Furthermore, A nomogram was used to predict the risk of brain invasion, and a decision curve was used to verify the clinical utility of the nomogram.

Results

According to stepwise logistic regression analysis, we found that sex, maximum diameter, peritumoral edema and ADC_min were closely related to brain invasion in meningioma. The model of the above four variables has the optimal discriminative ability to predict brain invasion, with an AUC of 0.924 (95 % CI, 0.879–0.969) and a sensitivity of 92.2 % (95 % CI, 74.5%–98.0 %).

Conclusions

Combining clinical features, MRI morphological characteristics and ADC_min, the model exhibits excellent discriminatory ability and high sensitivity, which can be used for predicting the risk of brain invasion of meningiomas.