Noninvasive Differentiation of Meningiomas and Dural Metastases Using Intratumoral Vascularity Obtained by Arterial Spin Labeling

Clin Neuroradiol. 2020 Sep;30(3):599-605. doi: 10.1007/s00062-019-00808-x. Epub 2019 Jun 26.

Abstract

Purpose: Using conventional magnetic resonance imaging (MRI) techniques, the imaging features of meningiomas and dural metastases overlap and a differentiation between these tumor entities therefore remains difficult, particularly in patients with a known primary neoplasm. The purpose of this study was to explore the potential role of normalized vascular intratumoral signal intensity values (nVITS) obtained from pulsed arterial spin labeling (PASL) to differentiate between meningiomas and dural metastases.

Methods: In this study PASL was performed in 46 patients with meningiomas (n = 30) and dural metastases (n = 16) on a 3T scanner, in addition to the routine diagnostic imaging protocol. The ratio between the vascular signal intensity of the tumor and the contralateral normal white matter obtained by PASL images was defined as nVITS.

Results: Meningiomas showed significantly higher nVITS values compared to dural metastases (p < 0.001). The optimal nVITS cut-off value to differentiate between the 2 tumor entities was 1.989, with 100% sensitivity and 81.2% specificity.

Conclusion: The nVITS values obtained by PASL provide a fast and noninvasive MRI technique with which to differentiate between meningiomas and dural metastases in a routine clinical setting based on tumor vascularity.

Keywords: Brain metastases; Extra-axial brain tumors; Intratumoral neovascularization; Meningioma; Pulsed arterial spin labeling.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Diagnosis, Differential
  • Dura Mater / diagnostic imaging*
  • Dura Mater / pathology
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Angiography / methods*
  • Male
  • Meningeal Neoplasms / diagnostic imaging*
  • Meningeal Neoplasms / pathology
  • Meningioma / diagnostic imaging*
  • Meningioma / pathology
  • Middle Aged
  • Neoplasm Metastasis
  • Prospective Studies
  • Spin Labels*

Substances

  • Contrast Media
  • Spin Labels