Positive Progesterone Receptor Expression in Meningioma May Increase the Transverse Relaxation: First Prospective Clinical Trial Using Single-Shot Ultrafast T 2 Mapping

This project aims to investigate the diagnostic performance of multiple overlapping-echo detachment imaging (MOLED) technique-derived transverse relaxation time (T 2 ) maps in predicting progesterone receptor (PR) and S100 expression in meningiomas. 63 meningioma patients were enrolled from October 2021 to August 2022, who underwent a complete routine magnetic resonance imaging and T 2 MOLED, which can characterize the whole brain transverse relaxation time within 32 seconds in a single scan. After the surgical resection of meningiomas, the expression levels of PR and S100 were determined by an experienced pathologist using immunohistochemistry techniques. Histogram analysis was performed in tumor parenchyma based on the parametric maps. Independent t test and Mann-Whitney U test were applied for the comparison of histogram parameters between different groups, with a significance level of P  < .05. Logistic regression and receiver operating characteristic (ROC) analysis with 95% confidence interval were conducted for the diagnostic efficiency evaluation. PR-positive group had significantly elevated T 2 histogram parameters ( P  = .001-.049) compared to the PR-negative group. The multivariate logistic regression model with T 2 showed the highest area under the ROC curve (AUC) for predicting PR expression (AUC = 0.818). Additionally, the multivariate model also had the best diagnostic performance for predicting meningioma S100 expression (AUC = 0.768). The MOLED technique-derived T 2 maps can distinguish PR and S100 status in meningiomas preoperatively.