Preoperative assessment of meningioma stiffness using magnetic resonance elastography.

OBJECT The object of this study was to determine the potential of magnetic resonance elastography (MRE) to preoperatively assess the stiffness of meningiomas. METHODS Thirteen patients with meningiomas underwent 3D brain MRE examination to measure stiffness in the tumor as well as in surrounding brain tissue. Blinded to the MRE results, neurosurgeons made a qualitative assessment of tumor stiffness at the time of resection. The ability of MRE to predict the surgical assessment of stiffness was tested using a Spearman rank correlation. RESULTS One case was excluded due to a small tumor size. In the remaining 12 cases, both tumor stiffness alone (p = 0.023) and the ratio of tumor stiffness to surrounding brain tissue stiffness (p = 0.0032) significantly correlated with the surgeons' qualitative assessment of tumor stiffness. Results of the MRE examination provided a stronger correlation with the surgical assessment of stiffness compared with traditional T1- and T2-weighted imaging (p = 0.089), particularly when considering meningiomas of intermediate stiffness. CONCLUSIONS In this cohort, preoperative MRE predicted tumor consistency at the time of surgery. Tumor stiffness as measured using MRE outperformed conventional MRI because tumor appearance on T1- and T2-weighted images could only accurately predict the softest and hardest meningiomas.

[1]  K. Chinzei,et al.  Mechanical properties of brain tissue in tension. , 2002, Journal of biomechanics.

[2]  Y. Suzuki,et al.  Meningiomas: Correlation between MRI characteristics and operative findings including consistency , 2005, Acta Neurochirurgica.

[3]  Sally Freels,et al.  Prevalence estimates for primary brain tumors in the United States by age, gender, behavior, and histology. , 2010, Neuro-oncology.

[4]  C. Jack,et al.  Decreased brain stiffness in Alzheimer's disease determined by magnetic resonance elastography , 2011, Journal of magnetic resonance imaging : JMRI.

[5]  Hiroshi Iseki,et al.  1H-MRS of intracranial meningiomas: What it can add to known clinical and MRI predictors of the histopathological and biological characteristics of the tumor? , 2011, Clinical Neurology and Neurosurgery.

[6]  Clifford R. Jack,et al.  Magnetic resonance elastography of the brain , 2008, NeuroImage.

[7]  A. Manduca,et al.  Assessment of hepatic fibrosis with magnetic resonance elastography. , 2007, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[8]  B. Kendall,et al.  Comparison of consistency of meningiomas and CT appearances , 1979, Neuroradiology.

[9]  Ralph Sinkus,et al.  In vivo brain viscoelastic properties measured by magnetic resonance elastography , 2008, NMR in biomedicine.

[10]  A. Manduca,et al.  Magnetic resonance elastography by direct visualization of propagating acoustic strain waves. , 1995, Science.

[11]  J. Shirron,et al.  Evaluation of a material parameter extraction algorithm using MRI-based displacement measurements , 2000, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

[12]  H. Kashimura,et al.  Prediction of meningioma consistency using fractional anisotropy value measured by magnetic resonance imaging. , 2007, Journal of neurosurgery.

[13]  Dieter Klatt,et al.  The impact of aging and gender on brain viscoelasticity , 2009, NeuroImage.

[14]  C. Jack,et al.  11C PiB and structural MRI provide complementary information in imaging of Alzheimer's disease and amnestic mild cognitive impairment. , 2008, Brain : a journal of neurology.

[15]  R L Ehman,et al.  Complex‐valued stiffness reconstruction for magnetic resonance elastography by algebraic inversion of the differential equation , 2001, Magnetic resonance in medicine.

[16]  L. Xu,et al.  Magnetic resonance elastography of brain tumors: preliminary results , 2007, Acta radiologica.

[17]  T Ohira,et al.  Prediction of consistency of meningiomas with preoperative magnetic resonance imaging. , 1997, Surgical neurology.

[18]  Fredric B. Meyer,et al.  Use of preoperative magnetic resonance imaging T1 and T2 sequences to determine intraoperative meningioma consistency , 2011, Surgical neurology international.