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<meta name="DC.Title" content="Asynchrony in Peritumoral Resting-State Blood Oxygen Level–Dependent fMRI Predicts Meningioma Grade and Invasion" />
<meta name="DC.Identifier" content="10.3174/ajnr.A7154" />
<meta name="DC.Date" content="2021-05-13" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Meningioma grade is determined by histologic analysis, with detectable brain invasion resulting in a diagnosis of grade II or III tumor. However, tissue undersampling is a common problem, and invasive parts of the tumor can be missed, resulting in the incorrect assignment of a lower grade. Radiographic biomarkers may be able to improve the diagnosis of grade and identify targets for biopsy. Prior work in patients with gliomas has shown that the resting-state blood oxygen level–dependent fMRI signal within these tumors is not synchronous with normal brain. We hypothesized that blood oxygen level–dependent asynchrony, a functional marker of vascular dysregulation, could predict meningioma grade.

MATERIALS AND METHODS: We identified 25 patients with grade I and 11 patients with grade II or III meningiomas. Blood oxygen level–dependent time-series were extracted from the tumor and the radiographically normal control hemisphere and were included as predictors in a multiple linear regression to generate a blood oxygen level–dependent asynchrony map, in which negative values signify synchronous and positive values signify asynchronous activity relative to healthy brain. Masks of blood oxygen level–dependent asynchrony were created for each patient, and the fraction of the mask that extended beyond the contrast-enhancing tumor was computed.

RESULTS: The spatial extent of blood oxygen level–dependent asynchrony was greater in high (grades II and III) than in low (I) grade tumors ( P &lt; 0.001) and could discriminate grade with high accuracy (area under the curve = 0.88).

CONCLUSIONS: Blood oxygen level–dependent asynchrony radiographically discriminates meningioma grade and may provide targets for biopsy collection to aid in histologic diagnosis.

AUC
:   area under the curve
BOF
:   BOLD outside fraction
BOLD
:   blood oxygen level–dependent
FOF
:   FLAIR outside fraction" />
<meta name="DC.Contributor" content="P.B. Wu" />
<meta name="DC.Contributor" content="D.S. Chow" />
<meta name="DC.Contributor" content="P.D. Petridis" />
<meta name="DC.Contributor" content="M.B. Sisti" />
<meta name="DC.Contributor" content="J.N. Bruce" />
<meta name="DC.Contributor" content="P.D. Canoll" />
<meta name="DC.Contributor" content="J. Grinband" />
<meta name="article:published_time" content="2021-05-13" />
<meta name="article:section" content="FUNCTIONAL" />
<meta name="citation_title" content="Asynchrony in Peritumoral Resting-State Blood Oxygen Level–Dependent fMRI Predicts Meningioma Grade and Invasion" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Meningioma grade is determined by histologic analysis, with detectable brain invasion resulting in a diagnosis of grade II or III tumor. However, tissue undersampling is a common problem, and invasive parts of the tumor can be missed, resulting in the incorrect assignment of a lower grade. Radiographic biomarkers may be able to improve the diagnosis of grade and identify targets for biopsy. Prior work in patients with gliomas has shown that the resting-state blood oxygen level–dependent fMRI signal within these tumors is not synchronous with normal brain. We hypothesized that blood oxygen level–dependent asynchrony, a functional marker of vascular dysregulation, could predict meningioma grade.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We identified 25 patients with grade I and 11 patients with grade II or III meningiomas. Blood oxygen level–dependent time-series were extracted from the tumor and the radiographically normal control hemisphere and were included as predictors in a multiple linear regression to generate a blood oxygen level–dependent asynchrony map, in which negative values signify synchronous and positive values signify asynchronous activity relative to healthy brain. Masks of blood oxygen level–dependent asynchrony were created for each patient, and the fraction of the mask that extended beyond the contrast-enhancing tumor was computed.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The spatial extent of blood oxygen level–dependent asynchrony was greater in high (grades II and III) than in low (I) grade tumors (&lt;i&gt;P&lt;/i&gt; &amp;lt; 0.001) and could discriminate grade with high accuracy (area under the curve = 0.88).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Blood oxygen level–dependent asynchrony radiographically discriminates meningioma grade and may provide targets for biopsy collection to aid in histologic diagnosis.&lt;/p&gt;" />
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<meta name="twitter:title" content="Asynchrony in Peritumoral Resting-State Blood Oxygen Level–Dependent fMRI Predicts Meningioma Grade and Invasion" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Meningioma grade is determined by histologic analysis, with detectable brain invasion resulting in a diagnosis of grade II or III tumor. However, tissue undersampling is a common problem, and invasive parts of the tumor can be missed, resulting in the incorrect assignment of a lower grade. Radiographic biomarkers may be able to improve the diagnosis of grade and identify targets for biopsy. Prior work in patients with gliomas has shown that the resting-state blood oxygen level–dependent fMRI signal within these tumors is not synchronous with normal brain. We hypothesized that blood oxygen level–dependent asynchrony, a functional marker of vascular dysregulation, could predict meningioma grade.

MATERIALS AND METHODS: We identified 25 patients with grade I and 11 patients with grade II or III meningiomas. Blood oxygen level–dependent time-series were extracted from the tumor and the radiographically normal control hemisphere and were included as predictors in a multiple linear regression to generate a blood oxygen level–dependent asynchrony map, in which negative values signify synchronous and positive values signify asynchronous activity relative to healthy brain. Masks of blood oxygen level–dependent asynchrony were created for each patient, and the fraction of the mask that extended beyond the contrast-enhancing tumor was computed.

RESULTS: The spatial extent of blood oxygen level–dependent asynchrony was greater in high (grades II and III) than in low (I) grade tumors ( P &lt; 0.001) and could discriminate grade with high accuracy (area under the curve = 0.88).

CONCLUSIONS: Blood oxygen level–dependent asynchrony radiographically discriminates meningioma grade and may provide targets for biopsy collection to aid in histologic diagnosis.

AUC
:   area under the curve
BOF
:   BOLD outside fraction
BOLD
:   blood oxygen level–dependent
FOF
:   FLAIR outside fraction" />
<meta name="og-title" property="og:title" content="Asynchrony in Peritumoral Resting-State Blood Oxygen Level–Dependent fMRI Predicts Meningioma Grade and Invasion" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2021/05/13/ajnr.A7154" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Meningioma grade is determined by histologic analysis, with detectable brain invasion resulting in a diagnosis of grade II or III tumor. However, tissue undersampling is a common problem, and invasive parts of the tumor can be missed, resulting in the incorrect assignment of a lower grade. Radiographic biomarkers may be able to improve the diagnosis of grade and identify targets for biopsy. Prior work in patients with gliomas has shown that the resting-state blood oxygen level–dependent fMRI signal within these tumors is not synchronous with normal brain. We hypothesized that blood oxygen level–dependent asynchrony, a functional marker of vascular dysregulation, could predict meningioma grade.

MATERIALS AND METHODS: We identified 25 patients with grade I and 11 patients with grade II or III meningiomas. Blood oxygen level–dependent time-series were extracted from the tumor and the radiographically normal control hemisphere and were included as predictors in a multiple linear regression to generate a blood oxygen level–dependent asynchrony map, in which negative values signify synchronous and positive values signify asynchronous activity relative to healthy brain. Masks of blood oxygen level–dependent asynchrony were created for each patient, and the fraction of the mask that extended beyond the contrast-enhancing tumor was computed.

RESULTS: The spatial extent of blood oxygen level–dependent asynchrony was greater in high (grades II and III) than in low (I) grade tumors ( P &lt; 0.001) and could discriminate grade with high accuracy (area under the curve = 0.88).

CONCLUSIONS: Blood oxygen level–dependent asynchrony radiographically discriminates meningioma grade and may provide targets for biopsy collection to aid in histologic diagnosis.

AUC
:   area under the curve
BOF
:   BOLD outside fraction
BOLD
:   blood oxygen level–dependent
FOF
:   FLAIR outside fraction" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node91146--7" data-node-nid="91146" id="top-node-91146--8807735880" data-pisa="ajnr;ajnr.A7154v1" data-pisa-master="ajnr;ajnr.A7154" data-apath="/ajnr/early/2021/05/13/ajnr.A7154.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Asynchrony in Peritumoral Resting-State Blood Oxygen Level–Dependent fMRI Predicts Meningioma Grade and Invasion</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">P.B. Wu</span>, <span class="highwire-citation-author" data-delta="1">D.S. Chow</span>, <span class="highwire-citation-author" data-delta="2">P.D. Petridis</span>, <span class="highwire-citation-author" data-delta="3">M.B. Sisti</span>, <span class="highwire-citation-author" data-delta="4">J.N. Bruce</span>, <span class="highwire-citation-author" data-delta="5">P.D. Canoll</span> and <span class="highwire-citation-author" data-delta="6">J. Grinband</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2021,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A7154 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-91146--8807735880" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">P.B. Wu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the (P.B.W.), Columbia University, New York, New York</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurological Surgery (P.B.W., M.B.S., J.N.B.), Columbia University, New York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.B.%2BWu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wu%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.B.%2BWu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2700-9403" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.B. Wu</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D.S. Chow </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiological Sciences (D.S.C.), University of California Irvine, Irvine, California</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.S.%2BChow%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chow%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.S.%2BChow%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2359-7394" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.S. Chow</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P.D. Petridis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Psychiatry (P.D.P.), New York University, New York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.D.%2BPetridis%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Petridis%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.D.%2BPetridis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7608-5723" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.D. Petridis</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">M.B. Sisti </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurological Surgery (P.B.W., M.B.S., J.N.B.), Columbia University, New York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.B.%2BSisti%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sisti%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.B.%2BSisti%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3222-985X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.B. Sisti</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">J.N. Bruce </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurological Surgery (P.B.W., M.B.S., J.N.B.), Columbia University, New York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.N.%2BBruce%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bruce%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.N.%2BBruce%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6844-0286" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.N. Bruce</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">P.D. Canoll </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Pathology and Cell Biology (P.D.C.), Columbia University, New York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.D.%2BCanoll%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Canoll%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.D.%2BCanoll%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7001-0226" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.D. Canoll</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">J. Grinband </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Radiology (J.G.), Columbia University, New York, New York</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Psychiatry (J.G.), Columbia University, New York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BGrinband%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Grinband%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BGrinband%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7658-6755" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">P.B. Wu</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-2"><span class="name">D.S. Chow</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-3"><span class="name">P.D. Petridis</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">d</a>, </li><li class="contributor" id="contrib-4"><span class="name">M.B. Sisti</span><a id="xref-aff-2-2" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-5"><span class="name">J.N. Bruce</span><a id="xref-aff-2-3" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-6"><span class="name">P.D. Canoll</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">e</a> and </li><li class="last" id="contrib-7"><span class="name">J. Grinband</span><a id="xref-aff-6-1" class="xref-aff" href="#aff-6">f</a><span class="xref-sep">,</span><a id="xref-aff-7-1" class="xref-aff" href="#aff-7">g</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the (P.B.W.), Columbia University, New York, New York</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>Department of Neurological Surgery (P.B.W., M.B.S., J.N.B.), Columbia University, New York, New York</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Department of Radiological Sciences (D.S.C.), University of California Irvine, Irvine, California</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>d</sup>Department of Psychiatry (P.D.P.), New York University, New York, New York</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>e</sup>Department of Pathology and Cell Biology (P.D.C.), Columbia University, New York, New York</address></li><li class="aff"><a id="aff-6" name="aff-6"></a><address><sup>f</sup>Department of Radiology (J.G.), Columbia University, New York, New York</address></li><li class="aff"><a id="aff-7" name="aff-7"></a><address><sup>g</sup>Department of Psychiatry (J.G.), Columbia University, New York, New York</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to Jack Grinband, PhD, <span class="addr-line">New York State Psychiatric Institute, 1051 Riverside Drive, Room 6-103, New York, NY 10032</span>; e-mail: <span class="em-link"><span class="em-addr">jg2269{at}cumc.columbia.edu</span></span></li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/early/2021/05/13/ajnr.A7154.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Asynchrony in Peritumoral Resting-State Blood Oxygen Level–Dependent fMRI Predicts Meningioma Grade and Invasion</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2021, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A7154 </span></div>
  
  
  
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      <div class="highwire-cite-title">Asynchrony in Peritumoral Resting-State Blood Oxygen Level–Dependent fMRI Predicts Meningioma Grade and Invasion</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2021, </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A7154 </span></div>
  
  
  
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