Utility of texture analysis for objective quantitative ex vivo assessment of meningioma consistency: method proposal and validation

Background Tumor consistency is considered to be a critical factor for the surgical removal of meningiomas and its preoperative assessment is intensively studied. A significant drawback in the research of predictive methods is the lack of a clear shared definition of tumor consistency, with most authors resorting to subjective binary classification labeling the samples as “soft” and “hard.” This classification is highly observer-dependent and its discrete nature fails to capture the fine nuances in tumor consistency. To compensate for these shortcomings, we examined the utility of texture analysis to provide an objective observer-independent continuous measure of meningioma consistency. Methods A total of 169 texturometric measurements were conducted using the Brookfield CT3 Texture Analyzer on meningioma samples from five patients immediately after the removal and on the first, second, and seventh postoperative day. The relationship between measured stiffness and time from sample extraction, subjectively assessed consistency grade and histopathological features (amount of collagen and reticulin fibers, presence of psammoma bodies, predominant microscopic morphology) was analyzed. Results The stiffness measurements exhibited significantly lower variance within a sample than among samples ( p = 0.0225) and significant increase with a higher objectively assessed consistency grade ( p = 0.0161, p = 0.0055). A significant negative correlation was found between the measured stiffness and the time from sample extraction ( p