Is Apparent Diffusion Coefficient Value Measured on Picture Archiving and Communication System Workstation Helpful in Prediction of High-grade Meningioma?
S Hirunpat, N Sanghan, C Watcharakul, K Kayasut, N Ina, H Pornrujee
Hong Kong J Radiol 2016;19:84-90
DOI: 10.12809/hkjr1615346
Objective: To determine whether the apparent diffusion coefficient (ADC) value measured on picture archiving and communication system (PACS) workstation is helpful in prediction of high-grade meningioma (World Health Organization grade II and III).
Methods: A total of 28 patients (mean age, 58; range, 44-71 years) including 9 men and 19 women with histopathologically confirmed meningioma (20 benign, 7 atypical, and 1 malignant) between August 2010 and June 2014 were included in the study. All patients underwent preoperative standard brain imaging that routinely included diffusion-weighted imaging obtained at B value = 0 and 1000 s/mm2. Quantitative analysis of the ADC value of the tumour and mean normalised ADC ratio of the tumour compared with the contralateral normal white matter were calculated and analysed.
Results: The mean ADC value of atypical and malignant meningiomas (0.698 x 10-3 mm2/s ± 0.06 x 10-3 mm2/s) was significantly lower (p < 0.05) compared with that of benign meningiomas (0.83 x 10-3 mm2/s ± 0.37 x 10-3 mm2/s). The mean normalised ADC ratio in the atypical and malignant type (0.895 ± 0.09) was also lower than that in the benign type (1.05 ± 0.05) but was statistically insignificant (p = 0.06). Using a mean ADC value of less than 0.8 x 10-3 mm2/s as a predictor of high-grade meningioma gave a sensitivity of 75% (95% confidence interval, 34.9-96.8), specificity of 65% (40.8-84.6), positive predictive value of 46.2% (19.2-74.9), and negative predictive value of 86.7% (59.5-98.3).
Conclusions: The mean ADC value of atypical and malignant meningiomas, measured conveniently by PACS, was statistically significantly lower than that of benign meningiomas and may be a helpful method in the prediction of high-grade meningioma with considerable sensitivity and specificity.
中文摘要
從PACS系統工作站量得的表觀擴散係數對於預測高度惡性腦膜瘤是否有幫助？
S Hirunpat, N Sanghan, C Watcharakul, K Kayasut, N Ina, H Pornrujee
目的：：探討從影像存檔和通訊系統的工作站（PACS）量度得到的表觀擴散係數（ADC）對於預測高度惡性腦膜瘤（世界衛生組織II級和III級）是否有幫助。
方法：2010年8月至2014年6月期間經病理學證實為腦膜瘤的28名患者列入研究範圍，包括9男19女，平均年齡58歲（44-71歲）。患者中良性腦膜瘤20例、非典型腦膜瘤7例、惡性1例。所有患者接受標準的術前腦成像，一般包括B值=0和1000 s/mm2的彌散加權成像。然後計算腫瘤的ADC值和其與對側正常白質ADC的比值。
結果：非典型性和惡性腦膜瘤的平均ADC值（0.698 × 10-3 mm2/s ± 0.06 × 10-3 mm2/s）比良性腦膜瘤的平均ADC值（0.83 × 10-3 mm2/s ± 0.37 × 10-3 mm2/s）顯著為低（p<0.05）。腫瘤的ADC值和其與對側正常白質ADC的比值在非典型和惡性腦膜瘤（0.895 ± 0.09）也較良性腦膜瘤的低（1.05 ± 0.05），但未達統計學意義（p=0.06）。使用低於0.8 × 10-3 mm2/s的平均ADC值作為預測高度惡性腦膜瘤的敏感性為75%（95%置信區間34.9-96.8）、特異性65%（95%置信區間40.8-84.6）、陽性預測值46.2%（95%置信區間19.2-74.9）、陰性預測值86.7%（95%置信區間59.5-98.3）。
結論：從PACS量度出來的非典型和惡性腦膜瘤的平均ADC值比良性腦膜瘤明顯低，由於有一定的靈敏度和特異性，它可能是預測高度惡性腦膜瘤的一個有幫助的方法。