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Base MRI Imaging Characteristics of Meningioma Patients to Discuss the WHO Classification of Brain Invasion Otherwise
Xiao Luo1, Hong Jiang2, X J Liu1
1Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China.
Purpose:
Compared and analyzed the MRI imaging features of brain invasion otherwise benign (BIOB) meningiomas and WHO grade 1, grade 2 meningiomas, discussed the WHO grading of BIOB from the perspective of imaging.
Materials And Methods:
A retrospective analysis was performed on 675 meningiomas patients who carried on MRI examination from January 2006 to February 2022. Setting the 2022 Central nervous system (CNS) WHO Guidelines as the gold standard for pathological diagnosis. Statistical analysis of age, gender, and MRI features of meningiomas in relation to WHO grade and brain invasion.
Results:
Among 675 cases meningiomas, 543 (80.4%) were WHO grade 1, 123 (18.2%) were WHO grade 2, and 9 (1.3%) were WHO grade 3. There were 108 cases meningiomas with brain invasion (BI) (16.0%) and 567 cases without BI (84.0%). Among BI cases, 67 cases were BIOB. Compared the MRI features between BIOB and WHO grade 1 meningiomas, multivariate analysis demonstrated that the most strongly factors associated with distinguish them were enhancement degree, peritumoral edema, tumor-brain interface, fingerlike protrusion, mushroom sign, and bone invasion (AUC: 0.925 (0.901∼0.945), sensitivity: 0.925, specificity: 0.801). Compared the MRI features between BIOB and WHO grade 2 meningiomas, multivariate analysis demonstrated that the most strongly factors associated with distinguish them were enhancement degree and the tumor-brain interface (AUC: 0.779 (0.686∼0.841), sensitivity: 0.746, specificity: 0.732), their efficacy was slightly weaker.
Conclusions:
BIOB is more similar to WHO grade 2 meningiomas in clinical and imaging features than WHO grade 1, so we think that it may be reasonable to classify BIOB as WHO Grade 2 meningiomas in the guidelines.
Insights
Brain invasion otherwise benign (BIOB) meningiomas share more imaging features with WHO grade 2 tumors than grade 1. This study suggests classifying BIOB meningiomas as WHO grade 2 may be appropriate.
Area of Science:
- Neurosurgery
- Radiology
- Pathology
Background:
- Meningiomas are the most common primary intracranial tumors.
- Accurate grading of meningiomas is crucial for treatment planning and prognosis.
- Brain invasion otherwise benign (BIOB) meningiomas present a diagnostic challenge due to their benign histology but invasive behavior.
Purpose of the Study:
- To compare the MRI imaging features of BIOB meningiomas with WHO grade 1 and grade 2 meningiomas.
- To evaluate the utility of MRI in differentiating BIOB meningiomas from other grades.
- To discuss the potential WHO grading of BIOB meningiomas based on imaging characteristics.
Main Methods:
- Retrospective analysis of 675 meningioma cases diagnosed via MRI between January 2006 and February 2022.
- Utilized the 2022 Central nervous system (CNS) WHO Guidelines for pathological diagnosis.
- Performed statistical analysis of patient demographics and MRI features in relation to WHO grade and brain invasion.
Main Results:
- Out of 675 meningiomas, 543 (80.4%) were WHO grade 1, 123 (18.2%) grade 2, and 9 (1.3%) grade 3.
- 108 cases (16.0%) showed brain invasion (BI), with 67 classified as BIOB.
- MRI features distinguishing BIOB from WHO grade 1 included enhancement degree, peritumoral edema, tumor-brain interface, fingerlike protrusion, mushroom sign, and bone invasion (AUC: 0.925).
- MRI features distinguishing BIOB from WHO grade 2 included enhancement degree and tumor-brain interface (AUC: 0.779).
Conclusions:
- BIOB meningiomas exhibit imaging characteristics more aligned with WHO grade 2 meningiomas than WHO grade 1.
- The findings suggest that reclassifying BIOB meningiomas as WHO grade 2 may be a reasonable consideration for future guidelines.
- Advanced MRI analysis can aid in differentiating meningioma grades and identifying invasive potential.
