Use of magnetic resonance imaging features as radiomic markers in pre-operative evaluation of extra-axial tumor grade

BACKGROUND: Extra-axial tumors are one of the tumor groups with difficult primary differential diagnostics. Detection and standardization of radiomic markers are one of the main problems of our time.

AIM: To detect radiomic markers for preoperative assessment of extra-axial tumor grade.

MATERIALS AND METHODS: This study retrospective analyzed the magnetic resonance imaging (1.5 T) data of 156 patients with extra-axial tumors. Patients were divided into 2 groups: Group 1 (n=106) with perifocal changes and Group 2 (n=50) with extra-axial tumors without perifocal changes. Diffusion and perfusion sequences were included in the scanning protocol. The areas of interest include (1) the lesion and (2) the area of perifocal changes. Measurements were made from the lesion and the area of perifocal changes on ACD and DSС maps, DCE was analyzed.

RESULTS: The maximum lesion size in Group 1 was 2.2 cm (1.4; 4.3), whereas in 1.2 cm in Group 2 (0.9; 3.5). In Group 1, the diffusion restriction from the lesion was detected in 42 patients (39.6%), whereas 7 (14%) in Group 2. The maximum size of perifocal changes in Group 1 was 2.85 cm (1.5; 4.7). Diffusion restriction was detected in 52 (49.1%) cases. In Group 1, patients with verified meningioma multivariable linear regression analysis showed 3.3-times increase of rCBF of the maximum size of the lesion from the area of perifocal changes (βcoef. 3.3, CI: 1.27; 5.28), p=0.003; however, it demonstrated a 4-time decrease of rCBF (βcoef. 4 CI: -7.46; -0.71), p=0.02.

CONCLUSIONS: Perfusion and diffusion methods combined with anatomical sequences show potential use as radiomic markers for diagnostic assessment and treatment of extra-axial tumors. Further detection of radiomic functional markers from the area of perifocal changes has potential.