Skip to main content
SpringerLink
Log in

Arterial spin-labeling is useful for the diagnosis of residual or recurrent meningiomas

  • Neuro
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusions

ASL improved the detection rate of residual or recurrent meningiomas on NC/CE-T1WI among both radiology residents and general radiologists.

Key Points

• 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Abbreviations

ASL:

Arterial spin-labeling

CBF:

Cerebral blood flow

CE-T1WI:

Contrast-enhanced T1-weighted imaging

CNR:

Lesion-to-normal contrast-to-noise ratio

FOM:

Figure of merit

NC-T1WI:

Non-contrast T1-weighted imaging

PCASL:

Pseudocontinuous arterial spin-labeling

PWI:

Perfusion-weighted imaging

TBF:

Tumour blood flow

References

  1. Marosi C, Hassler M, Roessler K et al (2008) Meningioma. Crit Rev Oncol Hematol 67:153–171

    Article  Google Scholar 

  2. Louis D, Ohgaki H, Wiestler O et al (2016) WHO classification of tumours of the central nervous system, revised. IARC, Lyon

    Google Scholar 

  3. McKinstry CS, Worthington BS, Niendorf HP, Young IR (1986) Demonstration of meningeal contrast enhancement on magnetic resonance imaging. Acta Radiol Suppl 369:564–567

    CAS  PubMed  Google Scholar 

  4. Toh CH, Wei KC, Chang CN et al (2014) Assessment of angiographic vascularity of meningiomas with dynamic susceptibility contrast-enhanced perfusion-weighted imaging and diffusion tensor imaging. AJNR Am J Neuroradiol 35:263–269

    Article  CAS  Google Scholar 

  5. Martin AJ, Cha S, Higashida RT et al (2007) Assessment of vasculature of meningiomas and the effects of embolization with intra-arterial MR perfusion imaging: a feasibility study. AJNR Am J Neuroradiol 28:1771–1777

    Article  CAS  Google Scholar 

  6. Tamrazi B, Shiroishi MS, Liu CS (2016) Advanced imaging of intracranial meningiomas. Neurosurg Clin N Am 27:137–143

    Article  Google Scholar 

  7. Mori H, Kunimatsu A, Abe O et al (2012) Diagnostic ability of fluid-attenuated inversion recovery MR imaging to detect remnant or recurrent meningiomas after resection. Neuroradiol J 25:163–171

    Article  CAS  Google Scholar 

  8. Kimura H, Takeuchi H, Koshimoto Y et al (2006) Perfusion imaging of meningioma by using continuous arterial spin-labeling: comparison with dynamic susceptibility-weighted contrast-enhanced MR images and histopathologic features. AJNR Am J Neuroradiol 27:85–93

    CAS  PubMed  Google Scholar 

  9. Kawaji H, Koizumi S, Sakai N et al (2013) Evaluation of tumor blood flow after feeder embolization in meningiomas by arterial spin-labeling perfusion magnetic resonance imaging. J Neuroradiol 40:303–306

    Article  Google Scholar 

  10. Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39

    Article  CAS  Google Scholar 

  11. Dai W, Garcia D, de Bazelaire C, Alsop DC (2008) Continuous flow-driven inversion for arterial spin labeling using pulsed radio frequency and gradient fields. Magn Reson Med 60:1488–1497

    Article  Google Scholar 

  12. Alsop DC, Detre JA, Golay X et al (2015) Recommended implementation of arterial spin-labeled perfusion MRI for clinical applications: a consensus of the ISMRM perfusion study group and the European consortium for ASL in dementia. Magn Reson Med 73:102–116

    Article  Google Scholar 

  13. Kikuchi K, Hiwatashi A, Togao O et al (2017) Correlation between arterial spin-labeling perfusion and histopathological vascular density of pediatric intracranial tumors. J Neurooncol 135:561–569

    Article  Google Scholar 

  14. Wirestam R, Ryding E, Lindgren A et al (2000) Regional cerebral blood flow distributions in normal volunteers: dynamic susceptibility contrast MRI compared with 99mTc-HMPAO SPECT. J Comput Assist Tomogr 24:526–530

    Article  CAS  Google Scholar 

  15. Nezafat R, Stuber M, Ouwerkerk R, Gharib AM, Desai MY, Pettigrew RI (2006) B1-insensitive T2 preparation for improved coronary magnetic resonance angiography at 3 T. Magn Reson Med 55:858–864

    Article  Google Scholar 

  16. Kikuchi K, Hiwatashi A, Togao O et al (2015) 3D MR sequence capable of simultaneous image acquisitions with and without blood vessel suppression: utility in diagnosing brain metastases. Eur Radiol 25:901–910

    Article  Google Scholar 

  17. Chakraborty DP, Berbaum KS (2004) Observer studies involving detection and localization: modeling, analysis, and validation. Med Phys 31:2313–2330

    Article  Google Scholar 

  18. Chakraborty DP (2006) Analysis of location specific observer performance data: validated extensions of the jackknife free-response (JAFROC) method. Acad Radiol 13:1187–1193

    Article  Google Scholar 

  19. Zhang H, Rodiger LA, Shen T, Miao J, Oudkerk M (2008) Preoperative subtyping of meningiomas by perfusion MR imaging. Neuroradiology 50:835–840

    Article  Google Scholar 

  20. Koizumi S, Sakai N, Kawaji H et al (2015) Pseudo-continuous arterial spin labeling reflects vascular density and differentiates angiomatous meningiomas from non-angiomatous meningiomas. J Neurooncol 121:549–556

    Article  Google Scholar 

  21. Wang J, Zhang Y, Wolf RL, Roc AC, Alsop DC, Detre JA (2005) Amplitude-modulated continuous arterial spin-labeling 3.0-T perfusion MR imaging with a single coil: feasibility study. Radiology 235:218–228

    Article  Google Scholar 

  22. Maleki N, Dai W, Alsop DC (2012) Optimization of background suppression for arterial spin labeling perfusion imaging. MAGMA 25:127–133

    Article  Google Scholar 

  23. Wu WC, Lin SC, Wang DJ, Chen KL, Li YD (2013) Measurement of cerebral white matter perfusion using pseudocontinuous arterial spin labeling 3T magnetic resonance imaging–an experimental and theoretical investigation of feasibility. PLoS One 8:e82679

    Article  Google Scholar 

  24. Nagao E, Yoshiura T, Hiwatashi A et al (2011) 3D turbo spin-echo sequence with motion-sensitized driven-equilibrium preparation for detection of brain metastases on 3T MR imaging. AJNR Am J Neuroradiol 32:664–670

    Article  CAS  Google Scholar 

  25. McCarthy BJ, Davis FG, Freels S et al (1998) Factors associated with survival in patients with meningioma. J Neurosurg 88:831–839

    Article  CAS  Google Scholar 

  26. Jääskeläinen J, Haltia M, Servo A (1986) Atypical and anaplastic meningiomas: radiology, surgery, radiotherapy, and outcome. Surg Neurol 25:233–242

    Article  Google Scholar 

  27. Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL (1985) Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg 62:18–24

    Article  CAS  Google Scholar 

  28. Kanda T, Ishii K, Kawaguchi H, Kitajima K, Takenaka D (2014) High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology 270:834–841

    Article  Google Scholar 

  29. Quattrocchi CC, Mallio CA, Errante Y et al (2015) Gadodiamide and dentate nucleus T1 hyperintensity in patients with meningioma evaluated by multiple follow-up contrast-enhanced magnetic resonance examinations with no systemic interval therapy. Invest Radiol 50:470–472

    Article  Google Scholar 

Download references

Acknowledgements

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

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kazufumi Kikuchi, Akio Hiwatashi, Osamu Togao, Koji Yamashita, Ryotaro Kamei & Hiroshi Honda

  2. Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Koji Yoshimoto & Koji Iihara

  3. Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Satoshi O. Suzuki & Toru Iwaki

  4. MR Clinical Science, Philips Electronics Japan, 13-37, Kohnan 2-chome, Minato-ku, Tokyo, 108-8507, Japan

    Yuriko Suzuki

Authors
  1. Kazufumi Kikuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Akio Hiwatashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Osamu Togao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Koji Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ryotaro Kamei
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Koji Yoshimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Koji Iihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Satoshi O. Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Toru Iwaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yuriko Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Hiroshi Honda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akio Hiwatashi.

Ethics declarations

Guarantor

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.

Informed consent

Written informed consent was waived by the institutional review board.

Ethical approval

Institutional review board approval was obtained.

Methodology

• Retrospective

• Diagnostic or prognostic study

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kikuchi, K., Hiwatashi, A., Togao, O. et al. Arterial spin-labeling is useful for the diagnosis of residual or recurrent meningiomas. Eur Radiol 28, 4334–4342 (2018). https://doi.org/10.1007/s00330-018-5404-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-018-5404-4

Keywords

Search

Navigation