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Prediction of progression in skull base meningiomas: additional benefits of apparent diffusion coefficient value

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Abstract

A subset of benign (WHO grade I) skull base meningiomas show early progression/recurrence (P/R) in the first years after surgical resection. Besides, complete surgical resection may be difficult to achieve safely in skull base meningiomas due to complex neurovascular structures. The one main challenge in the treatment of skull base meningiomas is to determine factors that correlate with P/R. We retrospectively investigated the preoperative CT and MR imaging features for the prediction of P/R in skull base meningiomas, with emphasis on quantitative ADC values. Only patients had postoperative MRI follow-ups for more than 1 year (at least every 6 months) were included. From October 2006 to December 2015, total 73 patients diagnosed with benign (WHO grade I) skull base meningiomas were included (median follow-up time 41 months), and 17 (23.3%) patients had P/R (median time to P/R 28 months). Skull base meningiomas with spheno-orbital location, adjacent bone invasion, high DWI, and lower ADC value/ratio were significantly associated with P/R (P < 0.05). The cut-off points of ADC value and ADC ratio for prediction of P/R are 0.83 × 10− 3 mm2/s and 1.09 respectively, with excellent area under curve (AUC) values (0.86 and 0.91) (P < 0.05). In multivariate logistic regression, low ADC values (< 0.83 × 10− 3 mm2/s) and adjacent bone invasion are high-risk factors of P/R (P < 0.05), with odds ratios of 31.53 and 17.59 respectively. The preoperative CT and MRI features for prediction of P/R offered clinically vital information for the planning of treatment in skull base meningiomas.

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Authors and Affiliations

  1. Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan

    Ching-Chung Ko, Sher-Wei Lim & Yow-Ling Shiue

  2. Section of Neuroradiology, Department of Medical Imaging, Chi-Mei Medical Center, Tainan, Taiwan

    Ching-Chung Ko & Tai-Yuan Chen

  3. Department of Neurosurgery, Chi-Mei Medical Center, Chiali, Tainan, Taiwan

    Sher-Wei Lim

  4. Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan

    Sher-Wei Lim

  5. Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, Taiwan

    Tai-Yuan Chen

  6. Department of Radiology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan

    Jeon-Hor Chen

  7. Center for Functional Onco-Imaging of Radiological Sciences, School of Medicine, University of California, Irvine, CA, USA

    Jeon-Hor Chen

  8. Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan

    Chien-Feng Li

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Ko, CC., Lim, SW., Chen, TY. et al. Prediction of progression in skull base meningiomas: additional benefits of apparent diffusion coefficient value. J Neurooncol 138, 63–71 (2018). https://doi.org/10.1007/s11060-018-2769-9

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  • DOI: https://doi.org/10.1007/s11060-018-2769-9

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