Evaluation parameters between intra-voxel incoherent motion and diffusion-weighted imaging in grading and differentiating histological subtypes of meningioma: A prospective pilot study

Purpose: 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 MM were performed by using 2 b values (0,1000 s/mm(2)) and 12 b values (0-3500 s/mm(2)), 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 x 10(-3) mm(2)/s and 0.905 +/- 0.194 x 10(-3) mm(2)/s, respectively, p = 0.967. The D values were lower in Grade II meningiomas than in Grade I meningiomas (0.459 +/- 0.072 x 10(-3) mm(2)/s vs. 0.524 +/- 0.030 x 10(-3) mm(2)/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 x 10(-3) mm(2)/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 x 10(-3) mm(2)/s vs. 5.125 +/- 1.918 x 10(-3) mm(2)/s, p <0.001). D, rD and rf values correlated negatively with Ki-67 index while D* and rD* value had positive relation with 10-67 values. Conclusion: 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. (C) 2016 Elsevier B.V. All rights reserved.