title: Evaluation parameters between intra-voxel incoherent motion and diffusion-weighted imaging in grading and differentiating histological subtypes of meningioma: A prospective pilot study.
abstract: OBJECTIVE
  To prospectively evaluate the usage of intra-voxel incoherent motion (IVIM) magnetic resonance imaging (MRI) parameters in grading and differentiating histological subtypes of meningiomas and in comparing their ability with the traditional diffusion-weighted imaging (DWI) parameter (apparent diffusion coefficient, ADC).
  
  
  METHODS
  In this prospective study, 102 participants underwent IVIM MRI and DWI. Traditional DWI and IVIM MRI were performed by using 2 b values (0, 1000s/mm2) and 12 b values (0-3500s/mm2), respectively. Finally, the values of ADC and IVIM parameters were collected from 72 Grade I and 11 Grade II meningiomas.
  
  
  RESULTS
  The mean ADC values of Grade II and Grade I meningiomas were 0.909±0.268×10-3mm2/s and 0.905±0.194×10-3mm2/s, respectively, p=0.967. The D values were lower in Grade II meningiomas than in Grade I meningiomas (0.459±0.072×10-3mm2/s vs. 0.524±0.030×10-3mm2/s, respectively, p=0.005). In ROC curves, the cut-off D value that separated Grade II meningiomas from Grade I meningiomas was 0.479×10-3mm2/s with a sensitivity of 90.9% and a specificity of 76.7%. The secretory and angiomatous meningiomas had higher IVIM parameters than the other subtypes (all p<0.05). D* was significantly lower in fibrous meningiomas than in other meningiomas (2.783±1.179×10-3mm2/s vs. 5.125±1.918×10-3mm2/s, p<0.001). D, rD and rf values correlated negatively with Ki-67 index while D* and rD* value had positive relation with Ki-67 values.
  
  
  CONCLUSIONS
  IVIM MRI is a promising technique for distinguishing different grades of meningiomas. Different subtypes of meningiomas have different IVIM features, which may help to treatment decision and prognosis evaluation.
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai 200040, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Yiping
authors.affiliation: Department of Radiology, Queen Elizabeth Hospital, 30 Gascoigne Road, King's park, Kowloon, Hong Kong.
authors.forename: Shek
authors.initials: S
authors.lastname: Kawai
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai 200040, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Jianbo
authors.affiliation: Department of Radiology, Shanghai Cancer Center, Fudan University, 270 Dongan Road, Shanghai 200000, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai 200040, China. Electronic address: GengdaoyingGDY@163.com.
authors.forename: Geng
authors.initials: G
authors.lastname: Daoying
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai 200040, China. Electronic address: yinbo7@163.com.
authors.forename: Yin
authors.initials: Y
authors.lastname: Bo
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019394:Ki-67 Antigen / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging*; D008579:Meningioma / Q000145:classification* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009038:Motion; D010865:Pilot Projects; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index
chemical_list: D019394:Ki-67 Antigen
keywords: Diffusion-weighted imaging; Intra-voxel incoherent motion; Magnetic resonance imaging; Meningioma; Neoplasm grading