Preoperative Apparent Diffusion Coefficient Values for Differentiation between Low and High Grade Meningiomas: An Updated Systematic Review and Meta-Analysis

Yueh-Ting Tsai¹, Kuo-Chuan Hung^{2

3}, Yun-Ju Shih¹, Sher-Wei Lim^{4

5}, Cheng-Chun Yang¹, Yu-Ting Kuo^{1

6}, Jeon-Hor Chen^{7

8}, Ching-Chung Ko^{1

9

10}

Affiliations

¹ Department of Medical Imaging, Chi Mei Medical Center, Tainan 710, Taiwan.
² Department of Anesthesiology, Chi Mei Medical Center, Tainan 710, Taiwan.
³ Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan.
⁴ Department of Neurosurgery, Chi Mei Medical Center, Chiali, Tainan 722, Taiwan.
⁵ Department of Nursing, Min-Hwei College of Health Care Management, Tainan 736, Taiwan.
⁶ Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
⁷ Department of Radiological Sciences, University of California, Irvine, CA 92697, USA.
⁸ Department of Radiology, E-DA Hospital, I-Shou University, Kaohsiung 824, Taiwan.
⁹ Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan.
¹⁰ Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan.

PMID: 35328183
PMCID: PMC8947055
DOI: 10.3390/diagnostics12030630

Review

Preoperative Apparent Diffusion Coefficient Values for Differentiation between Low and High Grade Meningiomas: An Updated Systematic Review and Meta-Analysis

Yueh-Ting Tsai et al. Diagnostics (Basel). 2022.

. 2022 Mar 4;12(3):630.

doi: 10.3390/diagnostics12030630.

Authors

Yueh-Ting Tsai¹, Kuo-Chuan Hung^{2

3}, Yun-Ju Shih¹, Sher-Wei Lim^{4

5}, Cheng-Chun Yang¹, Yu-Ting Kuo^{1

6}, Jeon-Hor Chen^{7

8}, Ching-Chung Ko^{1

9

10}

Affiliations

¹ Department of Medical Imaging, Chi Mei Medical Center, Tainan 710, Taiwan.
² Department of Anesthesiology, Chi Mei Medical Center, Tainan 710, Taiwan.
³ Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan.
⁴ Department of Neurosurgery, Chi Mei Medical Center, Chiali, Tainan 722, Taiwan.
⁵ Department of Nursing, Min-Hwei College of Health Care Management, Tainan 736, Taiwan.
⁶ Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
⁷ Department of Radiological Sciences, University of California, Irvine, CA 92697, USA.
⁸ Department of Radiology, E-DA Hospital, I-Shou University, Kaohsiung 824, Taiwan.
⁹ Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan.
¹⁰ Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 804, Taiwan.

PMID: 35328183
PMCID: PMC8947055
DOI: 10.3390/diagnostics12030630

Abstract

The meta-analysis aimed to compare the preoperative apparent diffusion coefficient (ADC) values between low-grade meningiomas (LGMs) and high-grade meningiomas (HGMs). Medline, Cochrane, Scopus, and Embase databases were screened up to January 2022 for studies investigating the ADC values of meningiomas. The study endpoint was the reported ADC values for LGMs and HGMs. Further subgroup analyses between 1.5T and 3T MRI scanners, ADC threshold values, ADC in different histological LGMs, and correlation coefficients (r) between ADC and Ki-67 were also performed. The quality of studies was evaluated by the quality assessment of diagnostic accuracy studies (QUADAS-2). A χ2-based test of homogeneity was performed using Cochran’s Q statistic and inconsistency index (I2). Twenty-five studies with a total of 1552 meningiomas (1102 LGMs and 450 HGMs) were included. The mean ADC values (×10−3 mm2/s) were 0.92 and 0.79 for LGMs and HGMs, respectively. Compared with LGMs, significantly lower mean ADC values for HGMs were observed with a pooled difference of 0.13 (p < 0.00001). The results were consistent in both 1.5T and 3T MRI scanners. For ADC threshold values, pooled sensitivity of 69%, specificity of 82%, and AUC of 0.84 are obtained for differentiation between LGMs and HGMs. The mean ADC (×10−3 mm2/s) in different histological LGMs ranged from 0.87 to 1.22. Correlation coefficients (r) of mean ADC and Ki-67 ranged from −0.29 to −0.61. Preoperative ADC values are a useful tool for differentiating between LGMs and HGMs. Results of this study provide valuable information for planning treatments in meningiomas.

Keywords: ADC; DWI; MRI; meningioma; meta-analysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
PRISMA flowchart for study selection.

**Figure 2**
Forest plot for the pooled difference in mean ADC values between LGMs and HGMs. The pooled difference in mean ADC was 0.13 (95% CI = 0.08 to 0.17, p < 0.00001).

**Figure 3**
Forest plot for the pooled differences in mean ADC values between LGMs and HGMs in (a) 1.5T and (b) 3T MRI scanners. The pooled differences were 0.16 and 0.08, respectively (p < 0.001).

**Figure 4**
The (a) forest plot and (b) summary ROC curve in diagnostic test accuracy of ADC threshold values for differentiation between LGMs and HGMs. Pooled sensitivity of 69%, specificity of 82%, and AUC of 0.84 are obtained.

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Preoperative Apparent Diffusion Coefficient Values for Differentiation between Low and High Grade Meningiomas: An Updated Systematic Review and Meta-Analysis

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Preoperative Apparent Diffusion Coefficient Values for Differentiation between Low and High Grade Meningiomas: An Updated Systematic Review and Meta-Analysis

Authors

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Abstract

Conflict of interest statement

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