Signal Intensities in Preoperative MRI Do Not Reflect Proliferative Activity in Meningioma

Stefan Schob; Clara Frydrychowicz; Matthias Gawlitza; Lionel Bure; Matthias Preuß; Karl-Titus Hoffmann; Alexey Surov

doi:10.1016/j.tranon.2016.05.003

Signal Intensities in Preoperative MRI Do Not Reflect Proliferative Activity in Meningioma

Transl Oncol. 2016 Aug;9(4):274-9. doi: 10.1016/j.tranon.2016.05.003. Epub 2016 Jul 8.

Authors

Stefan Schob¹, Clara Frydrychowicz², Matthias Gawlitza³, Lionel Bure⁴, Matthias Preuß⁵, Karl-Titus Hoffmann³, Alexey Surov⁶

Affiliations

¹ Department of Neuroradiology, University Leipzig, Germany. Electronic address: stefan.Schob@medizin.uni-leipzig.de.
² Department of Neuropathology, University Leipzig, Germany.
³ Department of Neuroradiology, University Leipzig, Germany.
⁴ Department of Radiology, McGill University Health Center, Montreal General Hospital.
⁵ Department of Neurosurgery, University Leipzig, Germany.
⁶ Department of Diagnostic and Interventional Radiology, University Leipzig, Germany.

Abstract

Background: Identification of high-grade meningiomas in preoperative magnetic resonance imaging (MRI) is important for optimized surgical strategy and best possible resection. Numerous studies investigated subjectively determined morphological features as predictors of tumor biology in meningiomas. The aim of this study was to identify the predictive value of more reliable, quantitatively measured signal intensities in MRI for differentiation of high- and low-grade meningiomas and identification of meningiomas with high proliferation rates, respectively.

Patients and methods: Sixty-six patients (56 World Health Organization [WHO] grade I, 9 WHO grade II, and 1 WHO grade I) were included in the study. Preoperative MRI signal intensities (fluid-attenuated inversion recovery [FLAIR], T1 precontrast, and T1 postcontrast as genuine and normalized values) were correlated with Ki-67 expression in tissue sections of resected meningiomas. Differences between the groups (analysis of variance) and Spearman rho correlation were computed using SPSS 22.

Results: Mean values of genuine signal intensities of meningiomas in FLAIR, T1 native, and T1 postcontrast were 323.9 ± 59, 332.8 ± 67.9, and 768.5 ± 165.3. Mean values of normalized (to the contralateral white matter) signal intensities of meningiomas in FLAIR, T1 native, and T1 postcontrast were 1.5 ± 0.3, 0.8 ± 0.1, and 1.9 ± 0.4. There was no significant correlation between MRI signal intensities and WHO grade or Ki-67 expression. Signal intensities did not differ significantly between WHO grade I and II/III meningiomas. Ki-67 expression was significantly increased in high-grade meningiomas compared with low-grade meningiomas (P < 0.01). Objectively measured values of MRI signal intensities (FLAIR, T1 precontrast, and T1 postcontrast enhancement) did not distinguish between high-grade and low-grade meningiomas. Furthermore, there was no association between MRI signal intensities and Ki-67 expression representing proliferative activity.