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How to predict the consistency and vascularity of meningiomas by MRI: an institutional experience
Fabian Winter1, Julia Furtner2, Alexander Pleyel2
1Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.
Objective:
In surgery for meningiomas tumor location and extension is currently the only MRI characteristic used to predict the feasibility and difficulty of the resection. Key surgical tumor characteristics such as consistency and vascularity remain obscured until the tumor is exposed. We therefore aimed to identify MRI sequences able to predict these crucial meningioma features.
Methods:
We retrospectively reviewed our imaging database on cranial meningiomas and correlated MRI T2W, T1W, and FLAIR images with the consistency and vascularity reported by the surgeon in the operative notes. The reported consistency was classified into three grades [°I (soft) to °III (hard)]. Vascularity was grouped into little (°I) versus strong (°II). MRI signal intensity (SI) ratios were calculated with ROIs in the meningioma, the buccinator muscle and the frontal white matter.
Results:
Of the 172 reviewed patients, 44 met the strict inclusion criteria with respect to the quality of the OR notes. The included meningiomas were located at the convexity (11/44), falcine (3/44), skull base (14/44), and posterior fossa (16/44). Twenty-four meningiomas (54.5%) were classified as consistency grade (°)I, seven (15.9%) °II, and thirteen (29.5%) °III. The grade of vascularization was little in 12 and strong in 14. The higher the ratio on T2W images the softer (p = 0.020) and the more vascularized (p = 0.001) the tumor presented.
Discussion:
T2W MR images may be helpful to characterize meningiomas with regard to the expected consistency and grade of vascularization.
Insights
T2-weighted MRI sequences can predict meningioma tumor consistency and vascularity. This imaging technique helps surgeons anticipate tumor characteristics before surgery, improving surgical planning for meningiomas.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Current meningioma surgical planning relies on tumor location and extension via MRI.
- Key surgical characteristics like tumor consistency and vascularity are not predictable preoperatively.
- Predicting these features could enhance surgical strategy and patient outcomes.
Purpose of the Study:
- To identify specific MRI sequences capable of predicting meningioma tumor consistency and vascularity.
- To correlate MRI findings with intraoperatively assessed tumor characteristics.
Main Methods:
- Retrospective review of cranial meningioma cases with available MRI data.
- Correlation of T2-weighted (T2W), T1-weighted (T1W), and FLAIR MRI sequences with surgeon-reported tumor consistency (grades I-III) and vascularity (grades I-II).
- Calculation of MRI signal intensity (SI) ratios using regions of interest (ROIs) in the tumor, buccinator muscle, and frontal white matter.
Main Results:
- Of 172 reviewed patients, 44 met inclusion criteria.
- Higher SI ratios on T2W images correlated with softer tumor consistency (p=0.020).
- Higher SI ratios on T2W images also correlated with increased tumor vascularity (p=0.001).
Conclusions:
- T2W MRI sequences show potential for characterizing meningiomas.
- These sequences may help predict tumor consistency and vascularity prior to surgical intervention.
- This could lead to improved preoperative assessment and surgical planning for meningiomas.
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