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Are there predilection sites for intracranial meningioma? A population-based atlas
Sayied Abdol Mohieb Hosainey1, David Bouget2,3, Ingerid Reinertsen2,3
1Department of Neurosurgery, Bristol Royal Hospital for Children, Bristol, BS2 8BJ, UK. s.a.m.h@live.no.
Abstract:
Meningioma is the most common benign intracranial tumor and is believed to arise from arachnoid cap cells of arachnoid granulations. We sought to develop a population-based atlas from pre-treatment MRIs to explore the distribution of intracranial meningiomas and to explore risk factors for development of intracranial meningiomas in different locations. All adults (≥ 18 years old) diagnosed with intracranial meningiomas and referred to the department of neurosurgery from a defined catchment region between 2006 and 2015 were eligible for inclusion. Pre-treatment T1 contrast-enhanced MRI-weighted brain scans were used for semi-automated tumor segmentation to develop the meningioma atlas. Patient variables used in the statistical analyses included age, gender, tumor locations, WHO grade and tumor volume. A total of 602 patients with intracranial meningiomas were identified for the development of the brain tumor atlas from a wide and defined catchment region. The spatial distribution of meningioma within the brain is not uniform, and there were more tumors in the frontal region, especially parasagittally, along the anterior part of the falx, and on the skull base of the frontal and middle cranial fossa. More than 2/3 meningioma patients were females (p < 0.001) who also were more likely to have multiple meningiomas (p < 0.01), while men more often have supratentorial meningiomas (p < 0.01). Tumor location was not associated with age or WHO grade. The distribution of meningioma exhibits an anterior to posterior gradient in the brain. Distribution of meningiomas in the general population is not dependent on histopathological WHO grade, but may be gender-related.
Insights
This study mapped intracranial meningiomas using MRI, revealing a non-uniform distribution, particularly in the frontal regions. Meningioma development shows a gender predisposition, with females more affected.
Area of Science:
- Neurosurgery
- Radiology
- Epidemiology
Background:
- Meningiomas are the most common benign intracranial tumors, often arising from arachnoid cap cells.
- Understanding their distribution and risk factors is crucial for diagnosis and treatment.
Purpose of the Study:
- To develop a population-based atlas of intracranial meningiomas using pre-treatment MRI.
- To explore the spatial distribution and potential risk factors associated with meningioma development in different brain locations.
Main Methods:
- Utilized pre-treatment T1 contrast-enhanced MRI scans from 602 adult patients diagnosed with intracranial meningiomas.
- Employed semi-automated tumor segmentation to create a meningioma atlas.
- Analyzed patient variables including age, gender, tumor location, WHO grade, and tumor volume.
Main Results:
- Identified a non-uniform spatial distribution of meningiomas, with a higher prevalence in the frontal regions, along the anterior falx, and on the skull base.
- Revealed that over two-thirds of meningioma patients were female, and females were more prone to multiple meningiomas.
- Observed that men more frequently had supratentorial meningiomas.
- Found no association between tumor location and age or WHO grade.
- Demonstrated an anterior-to-posterior gradient in meningioma distribution within the brain.
Conclusions:
- The spatial distribution of intracranial meningiomas is not uniform and exhibits an anterior-to-posterior gradient.
- Meningioma distribution is not dependent on histopathological WHO grade but appears to be gender-related.
- Females are more commonly affected and may have a higher likelihood of multiple meningiomas.
