Apparent diffusion coefficient values in differential diagnosis and prognostic prediction of solitary of fibrous tumor/hemangiopericytoma (WHOII) and atypical meningioma

Abstract

BACKGROUND:

It is difficult to distinguish solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) from atypical meningioma (AM) by conventional imaging.As far as we know,diffusion weighting imaging may identify them effectively.

OBJECTIVE:

The purpose of this study was to determine the role of apparent diffusion coefficient (ADC) values to distinguish and predict prognosis of solitary of fibrous tumor/hemangiopericytoma (SFT/HPC) (WHOII) and atypical meningioma (AM).

METHODS:

Preoperative diffusion-weighted imaging (DWI) of 30 cases with histopathologic and immunhistochemical testified SFT/HPC WHOII ( $n=$ 11) and AM ( $n=$ 19) were performed retrospectively. The ADC values of lesion, peritumoral edema, normal white matter and lesion NADC ratio (lesion ADC values/ADC values of normal white matter (NWN ADC)) were compared. The immunhistochemical markers (Ki-67, CD34, Vim, EMA, GFAP, S-100, PR, CD56) were compared. The correlation between the ADC values and Ki-67 index was evaluated.

RESULTS:

The mean lesion ADC values of SFT/HPC (1.15 $\pm$ 0.04 $\times$ 10 ${}^{-3}$ mm ${}^{2}$ /s) was significantly higher than that of AM (0.80 $\pm$ 0.04 $\times$ 10 ${}^{-3}$ mm ${}^{2}$ /s) ( $t=$ 23.824, $p<$ 0.05). The mean NADC ratio was lower for AM (1.03 $\pm$ 0.06) compared with SFT/HPC (1.51 $\pm$ 0.05) ( $t=$ 23.105, $p<$ 0.05). The mean edema ADC for SFT/HPC (1.47 $\pm$ 0.06 $\times$ 10 ${}^{-3}$ mm ${}^{2}$ /s) was lower compared with AM (1.68 $\pm$ 0.05 $\times$ 10 ${}^{-3}$ mm ${}^{2}$ /s) ( $t=$ $-$ 9.926, $p<$ 0.05 ). There was no statistical difference between the two groups of NWM ADC ( $t=$ $-$ 1.475, $p>$ 0.05) . The mean Ki-67 of SFT/HPC (7.18 $\pm$ 2.60%) was lower than the mean Ki-67 of AM (13.58 $\pm$ 4.50%) ( $t=$ $-$ 4.934, $p<$ 0.05). The CD34 showed statistically differences between two groups ( $X^{2}=$ 13.659, $p<$ 0.05). The EMA also showed statistically differences between two groups ( $X^{2}=$ 4.474, $p<$ 0.05). Vim,GFAP, S-100, PR, CD56 showed no statistical difference in the two group ( $p>$ 0.05). The pearson analysis indicated that there was a negative correlation between lesion ADC and Ki-67 in SFT/HPC group ( $r=$ $-$ 0.770, $p<$ 0.05) and AM group ( $r=$ $-$ 0.727, $p<$ 0.05). There was also a negative correlation between lesion NADC ratio and Ki-67 in SFT/HPC group ( $r=$ $-$ 0.673, $p<$ 0.05) and AM group ( $r=$ $-$ 0.707, $p<$ 0.05). There was a positive correlation between edema ADC and Ki-67 in SFT/HPC group ( $r=$ 0.819, $p<$ 0.05) and AM group ( $r=$ 0.942, $p<$ 0.05). Furthermore,there was no correlation between NWM A DC and Ki-67 in SFT/HPC group ( $r=$ $-$ 0.403, $p>$ 0.05) and AM group ( $r=$ 0.202, $p>$ 0.05).

CONCLUSIONS:

The lesion ADC, lesion NADC ratio and edema ADC can distinguish the SFT/HPC WHO II from AM and be helpful to predict prognosis of the two tumors before operation. Further more, histopathologic and immunhistochemical can make a definite diagnosis of the two tumors.

Keywords

Solitary of fibrous tumor/hemangiopericytoma atypical meningioma ADC Ki-67 CD34 EMA

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