A retrospective multicenter study reveals high diagnostic accuracy for an MRI scoring system in intracranial solitary fibrous tumors, suggesting improved differentiation from meningiomas.
Key Points
To develop and validate an MRI-based diagnostic score (ISFT-DS) for the standardized preoperative differentiation of intracranial solitary fibrous tumors from meningiomas.
Retrospective multicenter diagnostic accuracy study evaluating 1,000 patients (500 with ISFTs, 250 with low-grade meningiomas, and 250 with high-grade meningiomas) across development (n = 840) and external validation (n = 160) cohorts.
Three neuroradiologists assessed T1WI hyperintensity, honeycomb-like cystic change, and trans-compartmental growth on spin-echo T1WI, T2WI, and contrast-enhanced T1WI to build a 0–3-point diagnostic score (ISFT-DS).
Assessed diagnostic performance across cutoff values and evaluated the effect of standardized reader training among six readers.
At an ISFT-DS cutoff of ≥ 1, diagnostic sensitivity and specificity were 81.4% and 83.3% in the development cohort, and 76.3% and 86.3% in the external validation cohort.
Specificity rose to 98.3% (development) and 98.8% (validation) at a cutoff of ≥ 2, reaching 100% in both cohorts at a score of 3.
Interreader agreement was high (κ = 0.80–0.87), and standardized training improved overall diagnostic accuracy across readers from an AUC of 0.67 to 0.80 (ΔAUC = 0.13).