Correlation of apparent diffusion coefficient with Ki-67 proliferation index in grading meningioma

UMMS Affiliation

Department of Radiology; Department of Surgery; Department of Pathology

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Aged; Aged, 80 and over; Female; Humans; Ki-67 Antigen; Magnetic Resonance Imaging; Male; Meningeal Neoplasms; Meningioma; Middle Aged; Neoplasm Grading; Reproducibility of Results; Sensitivity and Specificity; Statistics as Topic; Tumor Markers, Biological


Neoplasms | Pathology | Radiology | Surgery


OBJECTIVE: A noninvasive method to predict aggressiveness of high-grade meningiomas would be desirable because it would help anticipate tumor recurrence and improve tumor management and the treatment outcomes. The Ki-67 protein is a marker of tumor proliferation, and apparent diffusion coefficient (ADC) is related to tumor cellularity. Therefore, we sought to determine whether there is a statistically significant correlation between ADC and Ki-67 values in meningiomas and whether ADC values can differentiate various meningioma subtypes.

MATERIALS AND METHODS: MRI examinations and histopathology of 68 surgically treated meningiomas were retrospectively reviewed. Mean ADC values were derived from diffusion imaging. Correlation coefficients were calculated for mean ADC and Ki-67 proliferation index values using linear regression. An independent unpaired Student t test was used to compare the ADC and Ki-67 proliferation index values from low-grade and more aggressive meningiomas.

RESULTS: A statistically significant inverse correlation was found between ADC and Ki-67 proliferation index for low-grade and aggressive meningiomas (r(2) = -0.33, p = 0.0039). ADC values (+/- SD) of low-grade meningiomas (0.84 +/- 0.14 x 10(-3) mm(2)/s) and aggressive (atypical or anaplastic) meningiomas (0.75 +/- 0.03 x 10(-3) mm(2)/s) were significantly different (p = 0.0495). Using an ADC cutoff value of 0.70 x 10(-3) mm(2)/s, the sensitivity for diagnosing aggressive meningiomas was 29%, specificity was 94%, positive predictive value was 67%, and negative predictive value was 75%.

CONCLUSION: ADC values correlate inversely with Ki-67 proliferation index and help differentiate low-grade from aggressive meningiomas.


apparent diffusion coefficient, diffusion-weighted imaging, Ki-67, meningioma grading, prognosis, recurrence

DOI of Published Version



AJR Am J Roentgenol. 2014 Jun;202(6):1303-8. doi: 10.2214/AJR.13.11637. Link to article on publisher's site

Journal/Book/Conference Title

AJR. American journal of roentgenology

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Link to Article in PubMed

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