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1- Department of Radiodiagnosis & Imaging Post Graduate Institute of Medical Sciences, Pt. B.D. Sharma University of Health Sciences, Rohtak 124 001 (Haryana), India
2- Department of Neurosurgery, Post Graduate Institute of Medical Sciences, Pt. B.D. Sharma University of Health Sciences, Rohtak 124 001 (Haryana), India
3- Department of Biotechnology & Molecular Medicine Regional Cancer Centre Post Graduate Institute of Medical Sciences, Pt. B.D. Sharma University of Health Sciences, Rohtak 124 001 (Haryana), India
Abstract:  

Purpose: The aim of this study was to grade meningiomas on the basis of relative cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) to help surgeon plan the approach and extent of surgery as well as judge the need of any adjuvant radio/chemo therapy. Current and evolving genomic, proteomic and spectroscopic technologies are discussed which can supplement the current radiologic methods and procedures in grading meningiomas.  
Methods: 35 meningioma patients prospectively underwent basic MR sequences (T1W, T2W, T2W/FLAIR) in axial, sagittal and coronal planes followed by diffusion weighted (DW) imaging with b value of 1000 (minimum ADC values  used for analysis). Then Gadobenate Dimeglumine/ Meglumine Gadoterate was administered in a dose of 0.1 mmol/kg at a rate of 4 ml/s followed by saline flush of 20 ml at a rate of 4 ml/s and T2*W/FFE dynamic images were acquired; dynamics showing maximum fall in intensity were used for creating rCBV and relative cerebral blood flow (rCBF) maps and calculating rCBV.
Results: Both maximum rCBV and minimum ADC within the tumor were not significant for differentiating benign from malignant meningiomas. A cut off maximum rCBV of 2.5 ml /100 g in peritumoral edema for differentiating benign from malignant meningiomas showed sensitivity of 75 %, specificity of 84.6 % and accuracy of 83.3 %.
Conclusions: Determination of maximum rCBV in peritumoral edema is useful in the preoperative differentiation between benign and malignant meningiomas. rCBV and ADC values within the tumor are not significant in differentiating benign from malignant tumors. rCBV values within tumor, however, may be helpful in subtyping meningiomas, specially transitional and meningothelial meningomas. 

Type of Study: Original | Subject: Clinical Neuroscience
Received: 2017/01/23 | Accepted: 2017/03/5 | Published: 2018/03/4

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