Differentiating Intracranial Solitary Fibrous Tumors from Atypical Meningiomas Using Conventional MRI: A Comparison of Radiomics Models Versus Assessment from Radiologists, and Exploration of Correlation with Collagen Volume Fraction.

Purpose: To investigate the performance of qualitative, quantitative assessment and radiomics models between solitary fibrous tumors (SFTs) and atypical meningiomas (ATMs), and the relationship between imaging parameters and collagen volume fraction (CVF). Methods: This study included 132 patients with ATMs and 50 patients with SFTs who underwent MRI. Qualitative assessment was performed using a five-point-scale visual scoring on T1WI and T2WI. Quantitative assessment was conducted by dividing the signal values of tumors by those of centrum semioval or thalamus. Radiomics models were established on T1WI, T2WI, and T1&T2WI. Spearman correlation was used to determine the correlation between CVF and imaging features. Results The AUCs and cutoff values of qualitative parameters were 0.913, > 3 on T1WI, and 0.763, ≤ 4 on T2WI in testing set. The AUCs were 0.854, 0.877, 0.942 for T1WI, T2WI and T1&T2WI models in testing set. There were significant differences between radiomics models and qualitative and quantitative assessment in training set ( P  < 0.05), while there were no significant differences in testing set. Among SFTs, negative correlation was obtained between CVF and qualitative and quantitative parameters on T1WI and T2WI. Conclusion The hyperintensity on T1WI and hypointensity on T2WI were valuable for discriminating SFTs and ATMs. The performance of radiomics models was superior to qualitative and quantitative parameters. The imaging parameters on T1WI and T2WI were negatively correlated with CVF among SFTs.