The value of whole-volume apparent diffusion coefficient histogram analysis in preoperatively distinguishing intracranial solitary fibrous tumor and transitional meningioma

PURPOSE: To investigate the value of whole-volume apparent diffusion coefficient (ADC) histogram analysis in preoperatively distinguishing intracranial solitary fibrous tumors (SFT) from transitional meningiomas (TM), thereby assisting the establishment of the treatment protocol. METHODS: Preoperative diffusion-weighted imaging datasets of 24 patients with SFT and 28 patients with TM were used to extract whole-volume ADC histogram parameters, including variance, skewness, kurtosis, and mean, as well as 1st (AP1), 10th (AP10), 50th (AP50), 90th (AP90), and 99th (AP99) percentiles of ADC using MaZda software. The independent t-test or Mann–Whitney U test was used to compare the differences between ADC histogram parameters of SFT and TM. Receiver operating characteristic (ROC) curves were generated to evaluate the performance of significant ADC histogram parameters. Spearman’s correlation coefficients were calculated to evaluate correlations between these parameters and the Ki-67 expression levels. RESULTS: SFT exhibited significantly higher variance, and lower AP1 and AP10 (all P < 0.05) than TM. The best diagnostic performance was obtained by variance, with an area under the ROC curve of 0.848 (0.722–0.933). However, there was no significant difference in skewness, kurtosis, mean, or other percentiles of ADC between the two groups (all P > 0.05). Significant correlations were also observed between the Ki-67 proliferation index and variance (r = 0.519), AP1 (r = -0.425), and AP10 (r = -0.372) (all P < 0.05). CONCLUSION: Whole-volume ADC histogram analysis is a feasible tool for non-invasive preoperative discrimination between intracranial SFT and TM, with variance being the most promising prospective parameter.