Amide Proton Transfer Weighted MR Imaging for Predicting Meningioma Stiffness: A Feasibility Study

Stiffness of meningioma is an important factor affecting the surgical resection and the prognosis of patients.To examine the feasibility of APTw-magnetic resonance imaging (MRI) in evaluating meningioma stiffness.Retrospective.Seventy-one patient with meningiomas, 39 were male and 32 were female; the mean age was 51 ± 10 years.3.0T; Turbo-spin-echo T1 -weighted and Gd-T1 -weighted sequence; Turbo-spin-echo T2 -weighted sequence; 2D fat-suppressed, turbo-spin-echo APTw pulse sequence.The T1 WI signal intensity score, T2 WI signal intensity score, APTwmin , APTwmax , and APTwmean values were compared between soft, medium stiff and stiff meningiomas or non-stiff meningiomas and stiff meningiomas group.Chi-square test, one-way ANOVA analysis, independent-samples t-test, intra-class correlation coefficient, rank-sum test, receiver operating characteristic curve analysis. P < 0.05 was considered statistically significant in all tests.APTwmin and APTwmean in the stiff group were significantly lower than that in the non-stiff group (2.79% ± 0.42% vs. 1.90% ± 0.60% and 3.20% ± 0.31% vs. 2.55% ± 0.61%). APTwmin and APTwmean in the stiff group were significantly lower than that in the medium stiff and soft groups (1.90% ± 0.60% vs. 2.69% ± 0.40% and 3.12% ± 0.32%, 2.55% ± 0.61% vs. 3.17% ± 0.33% and 3.39% ± 0.18%), APTwmin in the medium stiff group was significantly lower than in the soft group, there was no significant difference in APTwmean between the medium stiff and soft groups (P = 0.190). APTwmin showed the best diagnostic performance for evaluating meningioma stiffness with an area under the curve of 0.913, when the APTwmin was lower than 2.4%, the meningioma was defined as a stiff tumor, the sensitivity, specificity, and accuracy were 87.1%, 87.5%, and 85.9%, respectively.APTw-MRI could be used to evaluate meningioma stiffness, with APTwmin having the best evaluative efficiency.3 TECHNICAL EFFICACY: Stage 1.