{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:17:06Z","timestamp":1788308226637,"version":"build-2803163510"},"reference-count":71,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Despite advancements in imaging studies, the preoperative prediction of the biological behavior and intraoperative consistency of intracranial meningiomas remains limited. This study evaluated the association of volumetric diffusion-based and texture-derived radiomic features extracted from routine MRI with histopathological aggressiveness and intraoperative tumor consistency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Ninety-seven intracranial meningiomas resected at two tertiary centers were retrospectively analyzed. Volumetric segmentation was performed on contrast-enhanced T1-weighted MRI and coregistered to apparent diffusion coefficient (ADC) maps. Data on first-order diffusion metrics and selected texture features were collected. The associations between World Health Organization (WHO) grade and Ki-67 index were assessed using nonparametric tests and Spearman correlation analysis. Independent factors associated with intraoperative tumor consistency (Zada grades 1\u20135) were evaluated via multivariate ordinal logistic regression analysis that adjusted for tumor volume, skull base location, calcification status, and WHO grade. Secondary receiver operating characteristic (ROC) curve analyses were performed to differentiate solid (Zada grades 4\u20135) from soft (Zada grades 1\u20132) tumors. ROC analyses were performed within the study cohort and were intended as exploratory assessments of discriminative performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The mean ADC (ADCmean) and the 10th percentile of the ADC decreased significantly with increasing WHO grade (p &lt; 0.001). ADCmean had a moderate inverse correlation with the Ki-67 index (r = \u22120.42, p &lt; 0.001) and intraoperative tumor consistency (r = \u22120.45, p &lt; 0.001). In the multivariate analysis, the ADCmean remained independently associated with increasing tumor firmness. Each 0.1 \u00d7 10\n                      <jats:sup>\u22123<\/jats:sup>\n                      mm\n                      <jats:sup>2<\/jats:sup>\n                      \/sec increase corresponded to a 38% reduction in the odds of belonging to a higher consistency category (OR 0.62, 95% CI 0.51\u20130.74, p &lt; 0.001). The ROC analysis showed good discrimination for solid tumors (area under the curve 0.847, 95% CI 0.742\u20130.953) and soft tumors (area under the curve 0.824, 95% CI 0.714\u20130.935). Texture features had weaker associations with intraoperative tumor consistency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Volumetric diffusion-derived metrics, particularly ADCmean, are associated with both histopathological aggressiveness and intraoperative tumor firmness in meningiomas. Diffusion imaging may reflect a graded microstructural continuum rather than a purely dichotomous property, providing complementary preoperative insights into surgical complexity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.6.focus26251","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:01:04Z","timestamp":1787702464000},"page":"E18","source":"Crossref","is-referenced-by-count":0,"title":["Diffusion MRI radiomics in meningiomas: imaging correlates of tumor grade and intraoperative consistency"],"prefix":"10.3171","volume":"61","author":[{"given":"Sabino","family":"Luzzi","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sardinia;"},{"name":"Department of Neurosurgery, AOU Sassari, Sardinia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca Lorenzo","family":"Fabozzi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sardinia;"},{"name":"Department of Neurosurgery, AOU Sassari, Sardinia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Cutillo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, AOU Sassari, Sardinia;"},{"name":"Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tevfik Serhan","family":"Bora","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, AOU Sassari, Sardinia;"},{"name":"Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Pintus","sequence":"additional","affiliation":[{"name":"Department of Pathology, AOU Sassari, Sardinia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiano","family":"Cuccuru","sequence":"additional","affiliation":[{"name":"Department of Radiology, AOU Sassari, Sardinia, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Roskova","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Hospital Brno;"},{"name":"Faculty of Medicine, Masaryk University, Brno, Czech Republic;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abramo","family":"Agosti","sequence":"additional","affiliation":[{"name":"Department of Mathematics, University of Pavia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Magrassi","sequence":"additional","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia;"},{"name":"Department of Neurosurgery, Fondazione IRCCS Policlinico San Matteo, Pavia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sardinia;"},{"name":"Immuno-Oncology and Targeted Cancer Biotherapies, University of Sassari, Sardinia; and"},{"name":"Unit of Cancer Genetics, Institute of Genetic and Biomedical Research at the National Research Council, Sassari, Sardinia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Cossu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sardinia;"},{"name":"Department of Pathology, AOU Sassari, Sardinia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Scaglione","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sardinia;"},{"name":"Department of Radiology, AOU Sassari, Sardinia, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Masala","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Pharmacy, University of Sassari, Sardinia;"},{"name":"Department of Radiology, AOU Sassari, Sardinia, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Galzio","sequence":"additional","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Meningiomas, Their Classification, Regional Behavior, Life History and Surgical End Results","author":"Cushing H","year":"1938","unstructured":"Cushing H, Eisenhardt L. 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