Arterial spin-labeling is useful for the diagnosis of residual or recurrent meningiomas
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ASL is useful in evaluating tumour blood flow and in detecting hypervascular tumours. The purpose of this study was to assess the additive value of ASL to non-contrast and contrast-enhanced (NC/CE)-T1WI for diagnosing residual or recurrent meningiomas.
This retrospective study included 25 postoperative patients (20 women, 5 men; median age, 65 [32–85] years) with and 25 gender- and age-matched postoperative patients without residual or recurrent meningiomas. ASL was performed using a pseudocontinuous method. Seven independent observers (two radiology residents, two general radiologists and three neuroradiologists) participated in two reading sessions consisting of only NC/CE-T1WI (first session) or NC/CE-T1WI with ASL (second session). We evaluated the sensitivity and diagnostic performance for the detection of residual or recurrent meningiomas. The diagnostic performance was assessed using a figure of merit (FOM) calculated via jackknife free-response receiver-operating characteristics. Statistical analysis was performed with paired t tests, with a significance level of p < .05.
The sensitivities were as follows (NC/CE-T1WI vs. NC/CE-T1WI with ASL): residents (62.1% vs. 70.7%), general radiologists (75.9% vs. 87.9%), neuroradiologists (97.7% vs. 100%) and all observers (81.3% vs. 88.2%). The FOMs were as follows (NC/CE-T1WI vs. NC/CE-T1WI with ASL): residents (0.76 vs. 0.83), general radiologists (0.83 vs. 0.93), neuroradiologists (0.95 vs. 0.99) and all observers (0.86 vs. 0.93). The addition of ASL significantly improved the diagnostic parameters for all observers except neuroradiologists (p <. 05).
ASL improved the detection rate of residual or recurrent meningiomas on NC/CE-T1WI among both radiology residents and general radiologists.
• ASL improved diagnostic performance for residual/recurrent meningioma compare to NC/CE-T1WI alone.
• Diagnostic sensitivity was increased after adding ASL compared with NC/CE-T1WI.
• FOM was increased after adding ASL compared with NC/CE-T1WI.
KeywordsPerfusion-weighted MRI Residual tumour Local neoplasm recurrence Meningioma Cancer early detection
Cerebral blood flow
Contrast-enhanced T1-weighted imaging
Lesion-to-normal contrast-to-noise ratio
Figure of merit
Non-contrast T1-weighted imaging
Pseudocontinuous arterial spin-labeling
Tumour blood flow
Part of this work was presented at the 54th Annual Meeting of the American Society of Neuroradiology and Foundation of the ASNR Symposium, May 23–26, 2016; Washington, DC., USA: Number O-377
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Hiroshi Honda.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was waived by the institutional review board.
Institutional review board approval was obtained.
• Diagnostic or prognostic study
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