Diagnostic accuracy of diffusion weighted magnetic resonance imaging in differentiating benign and malignant meningioma taking histopathology as gold standard.

Objective: To evaluate the ability of diffusion-weighted MR Imaging to distinguish malignant meningiomas from benign, taking histopathology as the gold standard. Study Design: Cross-Sectional Validation Study. Setting: Department of Radiology, Aziz Fatimah Hospital and Allied Hospital, Faisalabad. Period: October 2024 to April 2025. Methods: A total of 225 patients aged between 20 to 60 years with suspected meningiomas were enrolled. DWI-MRI was performed using a 1.5 Tesla scanner (b-values 0, 500, and 1000 s/mm²). Findings were interpreted by a consultant radiologist and compared with histopathology. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated using SPSS version 20.0; a p-value < 0.05 was considered significant. Results: DWI-MRI showed a high diagnostic accuracy (86.67%) in distinguishing malignant from benign meningiomas, with sensitivity 88.52%, specificity 84.47%, PPV 87.10% and NPV 86.14% (p = 0.0001). Conclusion: DWI-MRI is a reliable, non-invasive imaging modality with high diagnostic accuracy for differentiating benign and malignant meningiomas and can significantly aid in preoperative assessment and treatment planning.