Preoperative Assessment and Prediction of Consistency of Intracranial Meningioma Utilizing the Apparent Diffusion Coefficient Values

Objectives Consistency of meningioma is important for preoperative planning, surgical resection, and predicting surgical outcomes. We prospectively evaluated the utility of the apparent diffusion coefficient (ADC) values to assess the consistency of meningioma. Methods Preoperative magnetic resonance imaging (MRI) was performed on 23 patients with meningioma before undergoing surgical resection and the average/mean of ADC minimum (ADC(min)), maximum (ADC(max)), and mean (ADC(mean)) values were calculated. Intraoperatively, the meningiomas were characterized as firm or soft and correlated with ADC values. Results ADC(min), ADC(max), and ADC(mean) values of soft and firm meningiomas were significantly different with a p-value of < 0.05. ADC(min) value of < 691.3 x 10(-6) mm(2)/s had 80% sensitivity and 84.6% specificity for identifying firm from the soft tumors with the area under the curve (AUC) = 0.862, p-value of 0.004, positive predictive value (PPV) 80, and negative predictive value (NPV) 84.6. ADC(max )value of <933.6 x 10(-6) mm(2)/s had 70% sensitivity and 84.6% specificity for identifying firm from the soft tumors with AUC= 0.823, p-value of 0.009, PPV 77.8, and NPV 78.6. ADC mean value of < 840.8 x 10(-6) mm(2)/s had 90% sensitivity and 76.9% specificity for identifying firm from the soft tumors with AUC = 0.900, p-value of 0.001, PPV 75, and NPV 90.9. Conclusion Diffusion-weighted MRI using ADC minimum, ADC maximum, and ADC mean values can be used to differentiate firm from soft meningiomas. Meningiomas intracranial with hard consistency showed relatively low ADC values.