Apparent Diffusion Coefficient (ADC) and Magnetic Resonance Imaging (MRI) Nomogram for Differentiating a Solitary Fibrous Tumor (World Health Organization Grade II) From an Angiomatous Meningioma

TL;DR

This study develops a diagnostic tool using MRI and ADC values to distinguish between two brain tumors, improving preoperative accuracy and surgical planning.

Contribution

A novel MRI-based nomogram integrating ADC values and conventional imaging features for differentiating solitary fibrous tumors from angiomatous meningiomas.

Findings

ADC values significantly differ between solitary fibrous tumors and angiomatous meningiomas.

Combining ADC with MRI features improves diagnostic accuracy for tumor differentiation.

The nomogram shows strong agreement between predicted and actual outcomes in validation.

Abstract

Introduction: Accurate preoperative differentiation between intracranial solitary fibrous tumor (SFT, World Health Organization grade II) and angiomatous meningioma (AM) is crucial for surgical planning and prognosis prediction. While conventional magnetic resonance imaging (MRI) is widely used, distinguishing these tumors based on imaging alone remains challenging. This study aimed to evaluate clinical and MRI features to improve diagnostic accuracy between SFT and AM, focusing on the apparent diffusion coefficient (ADC) and conventional MRI parameters.

Methods: A retrospective analysis was conducted on 51 patients (23 with SFT and 28 with AM) confirmed by pathology. Clinical and MRI characteristics were assessed using t-tests and chi-square tests. Logistic regression analysis was performed to identify independent predictors, and receiver operating characteristic (ROC) curve analysis evaluated diagnostic performance. A nomogram integrating ADC values with conventional MRI features was developed and validated using calibration curves.

Results: Significant differences in tumor shape, cystic necrosis, T1-weighted imaging and T2-weighted imaging signal intensities, and ADC values were observed between SFT and AM (p < 0.05). Logistic regression analysis confirmed these factors as independent predictors, with ADC demonstrating the highest diagnostic performance at an optimal cutoff value of 1.08 × 10-³ mm²/second. The ROC analysis showed that combining ADC with conventional MRI features improved diagnostic accuracy. The calibration curve demonstrated strong agreement between nomogram predictions and actual outcomes.

Conclusion: Integrating ADC values with clinical and MRI features provides a reliable method for differentiating intracranial SFT from AM. This approach enhances diagnostic precision, aiding in optimized clinical decision-making and surgical planning.

Figures