Differentiating intracranial solitary fibrous tumor/hemangiopericytoma from meningioma using diffusion-weighted imaging and susceptibility-weighted imaging.

Purpose: Intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) and meningioma are difficult to distinguish owing to their overlapping imaging manifestation on routine magnetic resonance imaging. The purpose of this study was to assess whether SFT/HPC can be differentiated from meningioma with diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI).

Methods: We retrospectively reviewed DWI, SWI, conventreional MR, and CT imaging features of 16 patients with SFT/HPC and 96 patients with meningioma. The apparent diffusion coefficient (ADC) value, normalized ADC (nADC) value, and degree of intratumoral susceptibility signal intensity (ITSS) were compared between SFT/HPCs and meningiomas using two-sample t tests, and among SFT/HPCs, low-grade and high-grade meningioma were tested using one-way analysis of variance (ANOVA). Receiver operating characteristic (ROC) curve and logistic regression analyses were performed to determine the differentiation capacity.

Results: The ADC value, nADC value, and the degree of ITSS in SFT/HPC were significantly higher than those in low-grade and high-grade meningiomas (all p < 0.05). The threshold value of > 1.15 for nADC provided 75.00% sensitivity and 60.42% specificity for differentiating SFT/HPC from meningioma. Compared with nADC, the degree of ITSS had a moderate sensitivity (62.50%) and a higher specificity (85.42%) using the threshold value of > 1.00. Furthermore, combining DWI and SWI can achieve a relatively high differentiation capacity with a sensitivity of 81.25% and specificity of 78.12%.

Conclusions: The nADC ratios and ITSS are useful for differentiating SFT/HPC from meningioma. Combining ITSS and nADC value appears to be a promising option for differential diagnosis.