Correlating apparent diffusion coefficients with histopathologic findings on meningiomas

Purpose: To determine whether the apparent diffusion coefficient (ADC) correlates with histopathologic findings and whether ADC values can be used to differentiate benign from atypical/malignant meningiomas.

Materials and methods: MR images were reviewed retrospectively in 138 patients with meningiomas treated between September 1997 and July 2003. The ADC values were measured in the lesions and peritumoral edema, and the normalized ADC (NADC) ratios were calculated using the formula NADC=ADC of the tumor/ADC of the normal white matter. The ADC findings were compared with the histopathologic findings after resection using the World Health Organization criteria (2007).

Results: Meningiomas were histologically graded as malignant (9%), atypical (14%) and benign (77%). Of the 138 meningiomas, 32 (23%) were atypical (n=19) or malignant (n=13), whereas 106 (77%) were typical. The mean ADC values were statistically different between typical and atypical/malignant meningiomas (0.97 ± 0.21 × 10(-3)mm(2)/s vs 0.85 ± 0.17 × 10(-3)mm(2)/s). The mean NADC ratios were also significantly lower in the atypical/malignant group (1.09 ± 0.23) than in the benign group (1.24 ± 0.25; P=0.002<0.05). The mean ADC values and NADC ratios did not differ significantly among fibrous, meningothelial, transitional and atypical tumors (P>0.05). The mean ADC values and NADC ratios were higher in the angiomatous and secretory subgroups than in the fibrous, meningothelial, transitional, atypical and malignant subgroups (P<0.05). The ADC values and NADC ratios were the lowest in the malignant subgroup, and the difference between atypical and malignant meningiomas was statistically significant (P<0.05).

Conclusions: Meningioma subgroups displayed different ADC values from each other. Thus, ADC values may provide a useful supplement to the information obtained from conventional contrast-enhanced MR imaging, enhancing the ability of medical professionals to differentiate among the subgroups of meningiomas.