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

Article type: Research Article

Authors: Lu, Ziwei^a | You, Zhiqun^b | Xie, Daohai^{a; *} | Wang, Zhongling^{c; *}

Affiliations: [a] Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China | [b] Department of Pathology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China | [c] Department of Radiology, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200080, China

Correspondence: [*] Corresponding authors: Daohai Xie, Department of Radiology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Road, Suzhou 215006, China. Tel.: +86 17712661998; E-mail: DHXie001@126.com. Zhongling Wang, Department of Radiology, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, No. 100 Haining Road, Shanghai 200080, China. Tel.: +86 13813675451; E-mail: zlwang138136@126.com.

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 ± 0.04 × 10-3 mm2/s) was significantly higher than that of AM (0.80 ± 0.04 × 10-3 mm2/s) (t= 23.824, p< 0.05). The mean NADC ratio was lower for AM (1.03 ± 0.06) compared with SFT/HPC (1.51 ± 0.05) (t= 23.105, p< 0.05). The mean edema ADC for SFT/HPC (1.47 ± 0.06 × 10-3 mm2/s) was lower compared with AM (1.68 ± 0.05 × 10-3 mm2/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 ± 2.60%) was lower than the mean Ki-67 of AM (13.58 ± 4.50%) (t=-4.934, p< 0.05). The CD34 showed statistically differences between two groups (X2= 13.659, p< 0.05). The EMA also showed statistically differences between two groups (X2= 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

DOI: 10.3233/THC-181447

Journal: Technology and Health Care, vol. 27, no. 2, pp. 137-147, 2019