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. 2022 Jun 21;19(7):1110-1117.
doi: 10.7150/ijms.73319. eCollection 2022.

The value of quantitative magnetic resonance imaging signal intensity in distinguishing between spinal meningiomas and schwannomas

Nguyen Duy Hung  1   2 , Le Thanh Dung  2   3 , Dang Khanh Huyen  1 , Ngo Quang Duy  4 , Dong-Van He  5 , Nguyen Minh Duc  6
Affiliations

The value of quantitative magnetic resonance imaging signal intensity in distinguishing between spinal meningiomas and schwannomas

Nguyen Duy Hung et al. Int J Med Sci. .

Abstract

Background: Prior studies have suggested a number of the subjective visual characteristics that help distinguish between spinal meningiomas and schwannomas on magnetic resonance imaging and computed tomography; however, objective quantification of the signal intensity can be useful information. This study assessed whether quantitative magnetic resonance imaging (MRI) signal intensity (SI) measurements could distinguish intradural-extramedullary schwannomas from meningiomas. Methods: From July 2019 to September 2021, 54 patients with intradural-extramedullary tumors (37 meningiomas and 17 schwannomas) underwent surgery, and tumors were verified pathologically. Defined regions of interest were used to quantify SI values on T1- (T1W) and T2-weighted images (T2W). Receiver operating characteristic curve analysis was used to obtain cutoff values and calculate the area under the curve (AUC), sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV). Results: Both Maximum (T2max) and mean (T2mean) T2W SI values demonstrated outstanding (AUC: 0.91) abilities to differentiate meningiomas from schwannomas with Se, Sp, PPV, and NPV values of 94.6%, 70.6%, 87.5%, and 85.7%, respectively, for T2max and 81.1%, 88.2%, 93.8%, and 68.2% for T2mean. The maximum SI value on contrast-enhanced T1W (T1CEmax) and the T2W tumor: fat SI ratio (rTF) demonstrated acceptable abilities (AUC: 0.73 and 0.79, respectively) to differentiate meningiomas from schwannomas with Se, Sp, PPV, and NPV values of 94.6%, 70.6%, 87.5%, and 85.7%, respectively, for T1CEmax and 81.1%, 88.2%, 93.8%, and 68.2% for rTF. Conclusions: Quantitative SI values (T2max, T2mean, T2min, T1CEmax, rTF) can be used to differentiate intradural-extramedullary schwannomas from meningiomas.

Keywords: magnetic resonance imaging; meningioma; quantitative measurement; schwannoma; spinal tumor.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
A representative region of interest defined for a tumor (white arrows). (A) Sagittal T1-weighted image, (B) sagittal T2-weighted image, and (C) sagittal contrast-enhanced T1-weighted fat-saturated image.
Figure 2
Figure 2
A representative region of interest on the tumor (white arrow) and 3 subcutaneous regions on axial T2-weighted image.
Figure 3
Figure 3
The receiver operating characteristic (ROC) curves for the minimum (T2min), maximum (T2max), and mean (T2mean) signal intensity values on T2-weighted images, the maximum signal intensity value on contrast-enhanced T1-weighted images (T1CEmax), and the tumor to fat signal intensity ratio (rTF). T2min, minimum signal intensity value on T2-weighted image (T2W); T2max, maximum signal intensity value on T2W; T2mean, mean signal intensity value on T2W; T1CEmax, maximum signal intensity value on contrast-enhanced T1-weighted image; rTF: tumor to fat signal intensity ratio on T2W.
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