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Background Presurgical grading is particularly important for selecting the best therapeutic strategy for meningioma patients. Purpose To investigate the value of histogram analysis of diffusion kurtosis imaging (DKI) maps in the differentiation of grades and histological subtypes of meningiomas. Material and Methods A total of 172 patients with histopathologically proven meningiomas underwent preoperative magnetic resonance imaging (MRI) and were classified into low-grade and high-grade groups. Mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD) histograms were generated based on solid components of the whole tumor. The following parameters of each histogram were obtained: 10th, 25th, 75th, and 90th percentiles, mean, median, maximum, minimum, and kurtosis, skewness, and variance. Comparisons of different grades and subtypes were made by Mann–Whitney U test, Kruskal–Wallis test, ROC curves analysis, and multiple logistic regression. Pearson correlation was used to evaluate correlations between histogram parameters and the Ki-67 labeling index. Results Significantly higher maximum, skewness, and variance of MD, mean, median, maximum, variance, 10th, 25th, 75th, and 90th percentiles of MK were found in high-grade than low-grade meningiomas (all P < 0.05). DKI histogram parameters differentiated 7/10 pairs of subtype pairs. The 90th percentile of MK yielded the highest AUC of 0.870 and was the only independent indicator for grading meningiomas. Various DKI histogram parameters were correlated with the Ki-67 labeling index ( P < 0.05). Conclusion The histogram analysis of DKI is useful for differentiating meningioma grades and subtypes. The 90th percentile of MK may serve as an optimal parameter for predicting the grade of meningiomas.

BackgroundNeoadjuvant therapy following minimally invasive esophagectomy is recommended as the standard treatment for locally advanced esophageal squamous carcinoma cells (ESCC). Postoperative atrial fibrillation (POAF) after esophagectomy is common. We aimed to determine the risk factors and construct a nomogram model to predict the incidence of POAF among patients receiving neoadjuvant therapy.MethodsWe retrospectively included patients with ESCC receiving neoadjuvant chemotherapy (nCT), neoadjuvant chemoradiotherapy (nCRT), or neoadjuvant immunochemotherapy (nICT) following minimally invasive esophagectomy (MIE) for analysis. Patients without a history of AF who did not have any AF before surgery and who developed new AF after surgery, were defined as having POAF. We applied a LASSO regression analysis to avoid the collinearity of variables and screen the risk factors. We then applied a multivariate regression analysis to select independent risk factors and constructed a nomogram model to predict POAF. We used the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) curve to evaluate the nomogram model.ResultsA total of 202 patients were included for analysis, with 35 patients receiving nCRT, 88 patients receiving nCT, and 79 patients receiving nICT. POAF occurred in 34 (16.83%) patients. There was no significant difference in the distribution of neoadjuvant types between the POAF group and the no POAF group. There was a significant increase in postoperative hospital stay (p = 0.04), hospital expenses (p = 0.01), and comprehensive complication index (p &lt; 0.001). The LASSO analysis screened the following as risk factors: blood loss; ejection fraction (EF); forced expiratory volume in 1 s; preoperative albumin (Alb); postoperative hemoglobin (Hb); preoperative Hb; hypertension; time to surgery; age; and left atrial (LA) diameter. Further, preoperative Alb ≤41.2 g/L (p &lt; 0.001), preoperative Hb &gt;149 g/L (p = 0.01), EF &gt;67.61% (p = 0.008), and LA diameter &gt;32.9 mm (p = 0.03) were determined as independent risk factors of POAF in the multivariate logistic analysis. The nomogram had an area under the curve (AUC) of 0.77. The Briser score of the calibration curve was 0.12. The DCA confirmed good clinical value.ConclusionsPreoperative Alb ≤41.2 g/L, LA diameter &gt;32.9 mm, preoperative Hb &gt;149 g/L, and EF &gt;67.61% were determined as the risk factors for POAF among patients with ESCC. A novel and valuable nomogram was constructed and validated to help clinicians evaluate the risk of POAF and take personalized treatment plans.