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Published on: January 9, 2019
Imaging score for differentiation of meningioma grade
Abigail Funari1, Rafael De la Garza Ramos2, Phillip Cezayirli2
1Albert Einstein College of Medicine, Department of Neurological Surgery, Bronx, NY, 10467, USA. abigail.funari@einsteinmed.edu.
Purpose:
We sought to establish a comprehensive imaging score indicating the likelihood of higher WHO grade meningiomas pre-operatively.
Methods:
All surgical intracranial meningioma patients at our institution between 2014 and 2018 underwent retrospective chart review. Preoperative MRI sequences were reviewed, and imaging features were included in the score based on statistical and clinical significance. Point values for each significant feature were assigned based on the beta coefficients obtained from multivariate analysis. The imaging score was calculated by adding up the points, for a total score of 0 to 5. The predictive ability of the score to identify higher-grade meningiomas was evaluated.
Results:
Ninety patients, 50% of whom had a postoperative diagnosis of WHO grade II meningioma, were included. The mean age for the population was 59.9 years and 70% were female. Tumor volume ≥ 36.0 cc was assigned 2 points, presence of irregular tumor borders was assigned 2 points, and presence of peritumoral edema was assigned 1 point. The probability of having a WHO grade II meningioma was 0% with a score of 0, 25.0% with a score of 1, 38.5% with a score of 2, 65.4% with a score of 3, and 83.3% with a score of 4 or greater. A threshold of ≥ 3 points achieved a recall of 0.80, precision of 0.73, F1-score of 0.77, accuracy of 0.76, and AUC of 0.82.
Conclusion:
The proposed imaging scoring system had good predictive capability for WHO grade II meningiomas with good discrimination and calibration. External validation is needed.
Insights
A new imaging score can help predict higher-grade meningiomas before surgery. This tool aids in assessing the likelihood of World Health Organization (WHO) grade II meningiomas, improving pre-operative planning.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Meningiomas are the most common primary intracranial tumors.
- Accurate pre-operative grading of meningiomas is crucial for treatment planning.
- Distinguishing higher-grade meningiomas (WHO grade II) pre-operatively remains a challenge.
Purpose of the Study:
- To develop and validate a comprehensive imaging scoring system for predicting World Health Organization (WHO) grade II meningiomas.
- To establish a pre-operative tool to estimate the likelihood of higher-grade meningiomas.
Main Methods:
- Retrospective review of 90 patients with intracranial meningiomas who underwent surgery.
- Analysis of preoperative MRI sequences to identify significant imaging features.
- Development of a scoring system based on tumor volume, irregular borders, and peritumoral edema.
Main Results:
- The developed imaging score effectively predicted WHO grade II meningiomas.
- A score of 3 or greater demonstrated a high probability (83.3%) of WHO grade II meningioma.
- The scoring system achieved a recall of 0.80, precision of 0.73, and an AUC of 0.82.
Conclusions:
- The proposed imaging score shows good predictive capability for identifying WHO grade II meningiomas.
- The scoring system offers good discrimination and calibration for pre-operative assessment.
- External validation is recommended to further confirm the utility of this imaging score.
