T2-Weighted Imaging and Apparent Diffusion Coefficient Histogram Parameters Predict Meningioma Consistency.

Rationale and Objectives: Preoperative prediction of meningioma consistency is of great clinical value for risk stratification and surgical approach selection. However, to date, objective quantitative criteria for predicting meningioma consistency have not been developed. This study aimed to investigate the predictive value of magnetic resonance imaging (MRI) T2-weighted imaging (T2WI) and apparent diffusion coefficient (ADC) histogram parameters for meningioma consistency. Materials and Methods: We retrospectively analyzed the clinical, preoperative MRI, and pathological data of 103 patients with histopathologically confirmed meningiomas. Histogram parameters (mean, variance, skewness, kurtosis, Perc.01%, Perc.10%, Perc.50%, Perc.90%, and Perc.99%) were calculated automatically on the whole tumor using MaZda software. Chi-square test, Mann-Whitney's U test, or independent samples t-test was used to compare clinical, conventional MRI features, and histogram parameters between soft and hard meningiomas. Receiver operating characteristic curve and binary logistic regression analysis were employed to assess the predictive performance of T2WI and ADC histogram parameters. Results: Tumor enhancement was the only conventional MRI feature that was statistically different between soft and hard meningiomas. ADC(mean), ADC(p1), ADC(p10), and ADC(p50) among ADC histogram parameters, and T2(mean), T2(p1), T2(p10), T2(p50), T2(p90), and T2(p99) among T2WI histogram parameters showed statistically significant differences between soft and hard meningiomas (all P < 0.05). We found that all combined variables (combined(all)) had the best accuracy in predicting meningioma consistency, with area under the curve, sensitivity, specificity, accuracy, positive predictive, and negative predictive values of 0.873 (0.804-0.941), 88.89%, 67.50%, 80.58%, 81.20%, and 79.40%, respectively. Among them, combined(T2) is the most beneficial for predicting meningioma consistency. Conclusion: Combined(T2) demonstrated better predictive performance for meningioma consistency than combined(ADC). T2WI and ADC histogram parameters may be imaging markers for predicting meningioma consistency.