Use of magnetic resonance elastography to gauge meningioma intratumoral consistency and histotype

Abstract

Objective: To determine whether tumor shear stiffness, as measured by magnetic resonance elastography, corresponds with intratumoral consistency and histotype. Materials and methods: A total of 88 patients with 89 meningiomas (grade 1, 74 typical [13 fibroblastic, 61 non-fibroblastic]; grade 2, 12 atypical; grade 3, 3 anaplastic) were prospectively studied, each undergoing preoperative MRE in conjunction with T1-, T2- and diffusion-weighted imaging. Contrast-enhanced T1-weighted sequences were also obtained. Tumor consistency was evaluated as heterogeneous or homogenous, and graded on a 5-point scale intraoperatively. MRE-determined shear stiffness was associated with tumor consistency by surgeon’s evaluation and whole-slide histologic analyses. Results: Mean tumor stiffness overall was 3.81+/-1.74 kPa (range, 1.57–12.60 kPa), correlating well with intraoperative scoring (r = 0.748; p = 0.001). MRE performed well as a gauge of tumor consistency (AUC = 0.879, 95 % CI: 0.792–0.938) and heterogeneity (AUC = 0.773, 95 % CI: 0.618–0.813), significantly surpassing conventional MR techniques (DeLong test, all p 0.05). Small (<2.5 cm, n = 6) and intraventricular (n = 2) tumors displayed inconsistencies between MRE and surgeon’s evaluation. Conclusions: The results of this prospective study provide substantial evidence that preoperative evaluation of meningiomas with MRE can reliably characterize tumor stiffness and spatial heterogeneity to aid neurosurgical planning.

Keywords

• Meningiomas
• Magnetic resonance imaging
• Elastography
• Mechanical properties
• Stiffness