Precise discrimination between meningiomas and schwannomas using time-to-signal intensity curves and percentage signal recoveries obtained from dynamic susceptibility perfusion imaging - 17/10/20

Doi : 10.1016/j.neurad.2020.09.008

Hakan Cebeci ^a,⁎ , Abidin Kilincer ^a, Halil İbrahim Duran ^a, Nusret Seher ^a, Mert Şahinoğlu ^b, Hakan Karabağlı ^b, Pınar Karabağlı ^c, Yahya Paksoy ^a,^d
^a Department of Radiology, Selcuk University, Faculty of Medicine, Konya, Turkey
^b Department of Neurosurgery, Selcuk University, Faculty of Medicine, Konya, Turkey
^c Department of Pathology, Selcuk University, Faculty of Medicine, Konya, Turkey
^d Department of Neuroradiology, Hamad Medical Corporation Neuroscience Institute, Doha, Qatar

^⁎Corresponding author at: Department of Radiology, Selçuk University, Medical Faculty, Selçuklu/Konya, 42130 Turkey.Department of RadiologySelçuk UniversityMedical FacultySelçuklu/Konya42130Turkey

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Saturday 17 October 2020
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Graphical abstract

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Highlights

•	Dynamic susceptibility contrast perfusion imaging (DSC-PI) is a commonly applied practical perfusion imaging technique that uses intravenous gadolinium.
•	This study investigated the accuracy of percentage signal recoveries obtained from dynamic susceptibility contrast perfusion imaging (DSC-PI) in discriminating meningiomas and schwannomas.
•	DSC-PI is a useful imaging tool for non-invasive discrimination of meningiomas and schwannomas.
•	Percentage signal recoveries discriminates meningiomas and schwannomas with higher sensitivity and specificity, compared to cerebral blood volume.

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Abstract

Background and purpose

Meningiomas and schwannomas are common extra-axial brain tumors. Discrimination is challenging in some locations when characteristic imaging features are absent. This study investigated the accuracy of percentage signal recoveries obtained from dynamic susceptibility contrast perfusion imaging (DSC-PI) in discriminating meningiomas and schwannomas.

Material and methods

Retrospective database research was conducted. Sixty nine meningioma and 15 schwannoma having DSC-PI between January 2016 and February 2020 were included. Time to signal intensity curves (TSIC) were analyzed and grouped as T1-dominant leakage, T2*-dominant leakage and return to baseline. Relative cerebral blood volume (rCBV), relative mean transit time (rMTT), percentage signal recovery 1 (PSR 1) and PSR 2 values were calculated. The differences between the groups were investigated. Receiver operating characteristic curves were operated.

Results

rCBV, rMTT, PSR 1 and PSR 2 values were statistically different between meningiomas and schwannomas. PSR 2 provided the best discrimination. With the cut off value of 1.08 for PSR 2, meningiomas and schwannomas were differentiated with 95.7% sensitivity and 93.3% specificity. TSICs were also different between two groups. Most of meningiomas showed T2*-dominant leakage (78.2%), whereas most of shwannomas showed T1-dominant leakage (93.3%).

Conclusion

DSC-PI is a useful imaging tool for non-invasive discrimination of meningiomas and schwannomas. Particularly, percentage signal recoveries discriminates meningiomas and schwannomas with high sensitivity and specificity.

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Keywords : Imaging, Magnetic resonance, Meningioma, Schwannoma, Percentage signal recovery, Perfusion