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Do aggressive imaging features correlate with advanced histopathological grade in meningiomas?
Chia-Chun Hsu1, Chien-Yu Pai, Hung-Wen Kao
1Department of Radiology, Buddhist Tzu Chi General Hospital, Taichung Branch, No. 66, Sec. 1, Fongsing Road, Tanzih Township, Taichung County 427, Taiwan.
Abstract:
Atypical and malignant meningiomas are more likely to recur than benign meningiomas. We aimed to distinguish atypical and malignant meningiomas from benign meningiomas based on imaging findings. Between 2004 and 2007, a total of 75 patients with resected intracranial meningiomas were retrospectively reviewed. Histopathological grades were assigned as benign and atypical/malignant meningiomas according to the World Health Organization (WHO) classification. All patients received preoperative CT scans and MRI studies. Six aggressive imaging features were evaluated and compared between the two groups: (i) intratumoral cystic change; (ii) hyperostosis of the adjacent skull; (iii) bony destruction; (iv) extracranial tumor extension through the skull base foramina; (v) arterial encasement; and (vi) peritumoral brain edema. There were 59 benign and 16 atypical/malignant meningiomas. Only intratumoral cystic change and extracranial tumor extension through the skull base foramina were more prevalent in atypical/malignant meningiomas (p=0.001). Hence, these two imaging features might be potential markers of atypical/malignant meningiomas.
Insights
Atypical and malignant meningiomas can be identified by specific imaging features. Intratumoral cystic change and extracranial extension are key indicators differentiating aggressive tumors from benign meningiomas.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- Atypical and malignant meningiomas exhibit higher recurrence rates compared to benign types.
- Accurate differentiation is crucial for treatment planning and prognosis.
Purpose of the Study:
- To identify distinct imaging features that differentiate benign meningiomas from atypical and malignant variants.
- To assess the diagnostic value of specific aggressive imaging characteristics.
Main Methods:
- Retrospective review of 75 patients with intracranial meningiomas (2004-2007).
- Histopathological grading based on World Health Organization (WHO) classification into benign and atypical/malignant groups.
- Evaluation of six aggressive imaging features on preoperative CT and MRI: intratumoral cystic change, hyperostosis, bony destruction, extracranial extension, arterial encasement, and peritumoral edema.
Main Results:
- The study included 59 benign and 16 atypical/malignant meningiomas.
- Intratumoral cystic change and extracranial tumor extension through skull base foramina were significantly more prevalent in atypical/malignant meningiomas (p=0.001).
- Other evaluated features did not show significant differences between groups.
Conclusions:
- Intratumoral cystic change and extracranial tumor extension are potential imaging markers for distinguishing atypical/malignant meningiomas from benign ones.
- These findings can aid radiologists and clinicians in preoperative risk stratification.
