The relationship between molecular subtypes and magnetic resonance perfusion in patients with brain meningioma.

Background: Meningiomas are the most common primary brain tumors, accounting for 15-20% of all primary brain tumors. Differentiating between malignant and benign meningiomas before surgery is essential for treatment planning and prognostic assessment. One proposed method for differentiating malignant from benign meningiomas is magnetic resonance (MR) perfusion (MR perfusion), but limited studies have been conducted in this respect. Therefore, this study aimed to determine the relationship between molecular subtypes and MR perfusion in patients with meningiomas. Methods: In this cross-sectional study, all patients with brain meningiomas referred to Sina Hospital in Tehran between 2021 and 2024 were evaluated prospectively. MR perfusion was done for patients. After brain surgery, pathological samples were obtained from the patients, and in addition to determining the conventional tumor grade, molecular studies including Ki-67, epidermal growth factor receptor amplification, and S100 were performed by the pathologist, and the results were recorded. The relationship between MR perfusion parameters (relative cerebral blood volume [rCBV], relative cerebral blood flow [rCBF], and mean transit time) with tumor-related data was assessed. The significance level was considered <0.05. Results: Twenty-five patients were studied. The mean age was 55.08 ± 12.07 years, and 17 patients (68%) were female. The most common presentation (76%) was headache. The findings showed that rCBV and rCBF were statistically significantly different between low-grade and high-grade tumors (P < 0.05). Although the calculated cut-offs for rCBV and rCBF (7.55 and 6.94, respectively) were useful for differentiating the different grades of disease, neither was statistically significant (P: 0.05 and P: 0.1, respectively). Furthermore, patients with higher Ki67 levels had higher rCBV and rCBF (P < 0.05 for both). Conclusion: MR perfusion values (rCBV and rCBF) have statistically significant differences between different grades of meningioma.