Higher-Resolution Magnetic Resonance Elastography in Meningiomas to Determine Intratumoral Consistency
Abstract BACKGROUND: Magnetic resonance elastography (MRE) analyzes shear wave movement through tissue to determine stiffness. In a prior study, measurements with first-generation brain MRE techniques correlated with intraoperative observations of overall meningioma stiffness. OBJECTIVE: To evaluate...
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| Veröffentlicht in: | Neurosurgery 2015-10, Vol.77 (4), p.653-659 |
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| creator | Hughes, Joshua D. Fattahi, Nikoo Van Gompel, J. Arani, Arvin Meyer, Fredric Lanzino, Giuseppe Link, Michael J. Ehman, Richard Huston, John |
| description | Abstract
BACKGROUND:
Magnetic resonance elastography (MRE) analyzes shear wave movement through tissue to determine stiffness. In a prior study, measurements with first-generation brain MRE techniques correlated with intraoperative observations of overall meningioma stiffness.
OBJECTIVE:
To evaluate the diagnostic accuracy of a higher-resolution MRE technique to preoperatively detect intratumoral variations compared with surgeon assessment.
METHODS:
Fifteen meningiomas in 14 patients underwent MRE. Tumors with regions of distinctly different stiffness were considered heterogeneous. Intratumoral portions were considered hard if there was a significant area ≥6 kPa. A 5-point scale graded intraoperative consistency. A durometer semiquantitatively measured surgical specimen hardness. Statistics included χ2, sensitivity, specificity, positive and negative predicative values, and Spearman rank correlation coefficient.
RESULTS:
For MRE and surgery, 9 (60%) and 7 (47%) tumors were homogeneous, 6 (40%) and 8 (53%) tumors were heterogeneous, 6 (40%) and 10 (67%) tumors had hard portions, and 14 (93%) and 12 (80%) tumors had soft portions, respectively. MRE sensitivity, specificity, and positive and negative predictive values were as follows: for heterogeneity, 75%, 100%, 100%, and 87%; for hardness, 60%, 100%, 100%, and 56%; and for softness, 100%, 33%, 86%, and 100%. Overall, 10 tumors (67%) matched well with MRE and intraoperative consistency and correlated between intraoperative observations (P = .02) and durometer readings (P = .03). Tumor size ⩽3.5 cm or vascular tumors were more likely to be inconsistent (P < .05).
CONCLUSION:
MRE was excellent at ruling in heterogeneity with hard portions but less effective in ruling out heterogeneity and hard portions, particularly in tumors more vascular or |
| doi_str_mv | 10.1227/NEU.0000000000000892 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4749919</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1227/NEU.0000000000000892</oup_id><sourcerecordid>1713945323</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6422-eb51123437ba2d1732bfa2df61e950bfa6bd16d5ddca14d3bcc515af8964093e3</originalsourceid><addsrcrecordid>eNqNkV1rFDEUhoModq3-A5EBb7yZNl_zkRtB1rUtVAWx4F3IZM7MpGaSNclY9t83y9ZSe6O5yeHkOS_vyYvQa4JPCKXN6ZfN1Ql-eFpBn6AVqSgvOeb4KVphwtuSifrHEXoR4zXGpOZN-xwd0ZqIhmK-QsO5GScI5TeI3i7JeFd8VqODZHSx7znlNBQbq2LyY1DbaVeYjIAzbjR-VrFIvvgICcJsHBQXLgWVltkHZYu1d9HEBE7vXqJng7IRXt3dx-jq0-b7-ry8_Hp2sf5wWeqaU1pCVxFCGWdNp2hPGka7IRdDTUBUONd115O6r_peK8J71mldkUoNrag5FgzYMXp_0N0u3Qy9hr0fK7fBzCrspFdG_v3izCRH_1vyhgtBRBZ4dycQ_K8FYpKziRqsVQ78EiVpCBO8YpRl9O0j9NovweX1JGVVU9G8S5spfqB08DEGGO7NECz3QcocpHwcZB5783CR-6E_yWWgPQA33ubfjz_tcgNBTqBsmv6lfXoY9cv2_9zcArQ2uiQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2357525118</pqid></control><display><type>article</type><title>Higher-Resolution Magnetic Resonance Elastography in Meningiomas to Determine Intratumoral Consistency</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Hughes, Joshua D. ; Fattahi, Nikoo ; Van Gompel, J. ; Arani, Arvin ; Meyer, Fredric ; Lanzino, Giuseppe ; Link, Michael J. ; Ehman, Richard ; Huston, John</creator><creatorcontrib>Hughes, Joshua D. ; Fattahi, Nikoo ; Van Gompel, J. ; Arani, Arvin ; Meyer, Fredric ; Lanzino, Giuseppe ; Link, Michael J. ; Ehman, Richard ; Huston, John</creatorcontrib><description>Abstract
BACKGROUND:
Magnetic resonance elastography (MRE) analyzes shear wave movement through tissue to determine stiffness. In a prior study, measurements with first-generation brain MRE techniques correlated with intraoperative observations of overall meningioma stiffness.
OBJECTIVE:
To evaluate the diagnostic accuracy of a higher-resolution MRE technique to preoperatively detect intratumoral variations compared with surgeon assessment.
METHODS:
Fifteen meningiomas in 14 patients underwent MRE. Tumors with regions of distinctly different stiffness were considered heterogeneous. Intratumoral portions were considered hard if there was a significant area ≥6 kPa. A 5-point scale graded intraoperative consistency. A durometer semiquantitatively measured surgical specimen hardness. Statistics included χ2, sensitivity, specificity, positive and negative predicative values, and Spearman rank correlation coefficient.
RESULTS:
For MRE and surgery, 9 (60%) and 7 (47%) tumors were homogeneous, 6 (40%) and 8 (53%) tumors were heterogeneous, 6 (40%) and 10 (67%) tumors had hard portions, and 14 (93%) and 12 (80%) tumors had soft portions, respectively. MRE sensitivity, specificity, and positive and negative predictive values were as follows: for heterogeneity, 75%, 100%, 100%, and 87%; for hardness, 60%, 100%, 100%, and 56%; and for softness, 100%, 33%, 86%, and 100%. Overall, 10 tumors (67%) matched well with MRE and intraoperative consistency and correlated between intraoperative observations (P = .02) and durometer readings (P = .03). Tumor size ⩽3.5 cm or vascular tumors were more likely to be inconsistent (P < .05).
CONCLUSION:
MRE was excellent at ruling in heterogeneity with hard portions but less effective in ruling out heterogeneity and hard portions, particularly in tumors more vascular or <3.5 cm. MRE is the first technology capable of prospectively evaluating intratumoral stiffness and, with further refinement, will likely prove useful in preoperative planning.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1227/NEU.0000000000000892</identifier><identifier>PMID: 26197204</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Adult ; Aged ; Brain - pathology ; Brain - surgery ; Brain cancer ; Elasticity Imaging Techniques - methods ; Female ; Humans ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Meningeal Neoplasms - diagnostic imaging ; Meningeal Neoplasms - surgery ; Meningioma - diagnostic imaging ; Meningioma - surgery ; Middle Aged ; Neurosurgery ; Prospective Studies ; Tumors ; Vein & artery diseases</subject><ispartof>Neurosurgery, 2015-10, Vol.77 (4), p.653-659</ispartof><rights>Copyright © 2015 by the Congress of Neurological Surgeons</rights><rights>Copyright © by the Congress of Neurological Surgeons</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6422-eb51123437ba2d1732bfa2df61e950bfa6bd16d5ddca14d3bcc515af8964093e3</citedby><cites>FETCH-LOGICAL-c6422-eb51123437ba2d1732bfa2df61e950bfa6bd16d5ddca14d3bcc515af8964093e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26197204$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hughes, Joshua D.</creatorcontrib><creatorcontrib>Fattahi, Nikoo</creatorcontrib><creatorcontrib>Van Gompel, J.</creatorcontrib><creatorcontrib>Arani, Arvin</creatorcontrib><creatorcontrib>Meyer, Fredric</creatorcontrib><creatorcontrib>Lanzino, Giuseppe</creatorcontrib><creatorcontrib>Link, Michael J.</creatorcontrib><creatorcontrib>Ehman, Richard</creatorcontrib><creatorcontrib>Huston, John</creatorcontrib><title>Higher-Resolution Magnetic Resonance Elastography in Meningiomas to Determine Intratumoral Consistency</title><title>Neurosurgery</title><addtitle>Neurosurgery</addtitle><description>Abstract
BACKGROUND:
Magnetic resonance elastography (MRE) analyzes shear wave movement through tissue to determine stiffness. In a prior study, measurements with first-generation brain MRE techniques correlated with intraoperative observations of overall meningioma stiffness.
OBJECTIVE:
To evaluate the diagnostic accuracy of a higher-resolution MRE technique to preoperatively detect intratumoral variations compared with surgeon assessment.
METHODS:
Fifteen meningiomas in 14 patients underwent MRE. Tumors with regions of distinctly different stiffness were considered heterogeneous. Intratumoral portions were considered hard if there was a significant area ≥6 kPa. A 5-point scale graded intraoperative consistency. A durometer semiquantitatively measured surgical specimen hardness. Statistics included χ2, sensitivity, specificity, positive and negative predicative values, and Spearman rank correlation coefficient.
RESULTS:
For MRE and surgery, 9 (60%) and 7 (47%) tumors were homogeneous, 6 (40%) and 8 (53%) tumors were heterogeneous, 6 (40%) and 10 (67%) tumors had hard portions, and 14 (93%) and 12 (80%) tumors had soft portions, respectively. MRE sensitivity, specificity, and positive and negative predictive values were as follows: for heterogeneity, 75%, 100%, 100%, and 87%; for hardness, 60%, 100%, 100%, and 56%; and for softness, 100%, 33%, 86%, and 100%. Overall, 10 tumors (67%) matched well with MRE and intraoperative consistency and correlated between intraoperative observations (P = .02) and durometer readings (P = .03). Tumor size ⩽3.5 cm or vascular tumors were more likely to be inconsistent (P < .05).
CONCLUSION:
MRE was excellent at ruling in heterogeneity with hard portions but less effective in ruling out heterogeneity and hard portions, particularly in tumors more vascular or <3.5 cm. MRE is the first technology capable of prospectively evaluating intratumoral stiffness and, with further refinement, will likely prove useful in preoperative planning.</description><subject>Adult</subject><subject>Aged</subject><subject>Brain - pathology</subject><subject>Brain - surgery</subject><subject>Brain cancer</subject><subject>Elasticity Imaging Techniques - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Meningeal Neoplasms - diagnostic imaging</subject><subject>Meningeal Neoplasms - surgery</subject><subject>Meningioma - diagnostic imaging</subject><subject>Meningioma - surgery</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Prospective Studies</subject><subject>Tumors</subject><subject>Vein & artery diseases</subject><issn>0148-396X</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkV1rFDEUhoModq3-A5EBb7yZNl_zkRtB1rUtVAWx4F3IZM7MpGaSNclY9t83y9ZSe6O5yeHkOS_vyYvQa4JPCKXN6ZfN1Ql-eFpBn6AVqSgvOeb4KVphwtuSifrHEXoR4zXGpOZN-xwd0ZqIhmK-QsO5GScI5TeI3i7JeFd8VqODZHSx7znlNBQbq2LyY1DbaVeYjIAzbjR-VrFIvvgICcJsHBQXLgWVltkHZYu1d9HEBE7vXqJng7IRXt3dx-jq0-b7-ry8_Hp2sf5wWeqaU1pCVxFCGWdNp2hPGka7IRdDTUBUONd115O6r_peK8J71mldkUoNrag5FgzYMXp_0N0u3Qy9hr0fK7fBzCrspFdG_v3izCRH_1vyhgtBRBZ4dycQ_K8FYpKziRqsVQ78EiVpCBO8YpRl9O0j9NovweX1JGVVU9G8S5spfqB08DEGGO7NECz3QcocpHwcZB5783CR-6E_yWWgPQA33ubfjz_tcgNBTqBsmv6lfXoY9cv2_9zcArQ2uiQ</recordid><startdate>201510</startdate><enddate>201510</enddate><creator>Hughes, Joshua D.</creator><creator>Fattahi, Nikoo</creator><creator>Van Gompel, J.</creator><creator>Arani, Arvin</creator><creator>Meyer, Fredric</creator><creator>Lanzino, Giuseppe</creator><creator>Link, Michael J.</creator><creator>Ehman, Richard</creator><creator>Huston, John</creator><general>Oxford University Press</general><general>Copyright by the Congress of Neurological Surgeons</general><general>Wolters Kluwer Health, Inc</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201510</creationdate><title>Higher-Resolution Magnetic Resonance Elastography in Meningiomas to Determine Intratumoral Consistency</title><author>Hughes, Joshua D. ; Fattahi, Nikoo ; Van Gompel, J. ; Arani, Arvin ; Meyer, Fredric ; Lanzino, Giuseppe ; Link, Michael J. ; Ehman, Richard ; Huston, John</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6422-eb51123437ba2d1732bfa2df61e950bfa6bd16d5ddca14d3bcc515af8964093e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Brain - pathology</topic><topic>Brain - surgery</topic><topic>Brain cancer</topic><topic>Elasticity Imaging Techniques - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Meningeal Neoplasms - diagnostic imaging</topic><topic>Meningeal Neoplasms - surgery</topic><topic>Meningioma - diagnostic imaging</topic><topic>Meningioma - surgery</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Prospective Studies</topic><topic>Tumors</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hughes, Joshua D.</creatorcontrib><creatorcontrib>Fattahi, Nikoo</creatorcontrib><creatorcontrib>Van Gompel, J.</creatorcontrib><creatorcontrib>Arani, Arvin</creatorcontrib><creatorcontrib>Meyer, Fredric</creatorcontrib><creatorcontrib>Lanzino, Giuseppe</creatorcontrib><creatorcontrib>Link, Michael J.</creatorcontrib><creatorcontrib>Ehman, Richard</creatorcontrib><creatorcontrib>Huston, John</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hughes, Joshua D.</au><au>Fattahi, Nikoo</au><au>Van Gompel, J.</au><au>Arani, Arvin</au><au>Meyer, Fredric</au><au>Lanzino, Giuseppe</au><au>Link, Michael J.</au><au>Ehman, Richard</au><au>Huston, John</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Higher-Resolution Magnetic Resonance Elastography in Meningiomas to Determine Intratumoral Consistency</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>2015-10</date><risdate>2015</risdate><volume>77</volume><issue>4</issue><spage>653</spage><epage>659</epage><pages>653-659</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><abstract>Abstract
BACKGROUND:
Magnetic resonance elastography (MRE) analyzes shear wave movement through tissue to determine stiffness. In a prior study, measurements with first-generation brain MRE techniques correlated with intraoperative observations of overall meningioma stiffness.
OBJECTIVE:
To evaluate the diagnostic accuracy of a higher-resolution MRE technique to preoperatively detect intratumoral variations compared with surgeon assessment.
METHODS:
Fifteen meningiomas in 14 patients underwent MRE. Tumors with regions of distinctly different stiffness were considered heterogeneous. Intratumoral portions were considered hard if there was a significant area ≥6 kPa. A 5-point scale graded intraoperative consistency. A durometer semiquantitatively measured surgical specimen hardness. Statistics included χ2, sensitivity, specificity, positive and negative predicative values, and Spearman rank correlation coefficient.
RESULTS:
For MRE and surgery, 9 (60%) and 7 (47%) tumors were homogeneous, 6 (40%) and 8 (53%) tumors were heterogeneous, 6 (40%) and 10 (67%) tumors had hard portions, and 14 (93%) and 12 (80%) tumors had soft portions, respectively. MRE sensitivity, specificity, and positive and negative predictive values were as follows: for heterogeneity, 75%, 100%, 100%, and 87%; for hardness, 60%, 100%, 100%, and 56%; and for softness, 100%, 33%, 86%, and 100%. Overall, 10 tumors (67%) matched well with MRE and intraoperative consistency and correlated between intraoperative observations (P = .02) and durometer readings (P = .03). Tumor size ⩽3.5 cm or vascular tumors were more likely to be inconsistent (P < .05).
CONCLUSION:
MRE was excellent at ruling in heterogeneity with hard portions but less effective in ruling out heterogeneity and hard portions, particularly in tumors more vascular or <3.5 cm. MRE is the first technology capable of prospectively evaluating intratumoral stiffness and, with further refinement, will likely prove useful in preoperative planning.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>26197204</pmid><doi>10.1227/NEU.0000000000000892</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Brain - pathology Brain - surgery Brain cancer Elasticity Imaging Techniques - methods Female Humans Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Meningeal Neoplasms - diagnostic imaging Meningeal Neoplasms - surgery Meningioma - diagnostic imaging Meningioma - surgery Middle Aged Neurosurgery Prospective Studies Tumors Vein & artery diseases |
| title | Higher-Resolution Magnetic Resonance Elastography in Meningiomas to Determine Intratumoral Consistency |
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