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A Prospective Study on Perfusion MRI Changes in Intracranial Meningiomas Following Gamma Knife Therapy
Bhoopendra Singh1, Deepak Agrawal2, Ajay Garg3
1Department of Neurosurgery, Hamdard Institute of Medical Sciences and Research, New Delhi, India.
Background:
Radiosurgery plays an important role as a treatment modality for intracranial meningiomas. Perfusion MR imaging can be performed by using arterial spin-labeling (ASL) which is a relatively new and advanced technique.
Objectives:
To assess the changes in perfusion parameters on ASL perfusion MRI in intracranial meningioma after radiosurgery and correlate with histopathological grade of meningioma.
Materials And Methods:
In this Prospective study done at the our institute over a period of 20 months (Jan 2016-Aug 2017), patients with intracranial meningiomas had perfusion MRI with ASL sequence on GE Optima 450W®, 1.5T MRI (GE Medical Systems) prior to GKT and at 6 months after GKT were included in the study.
Results:
Twenty-seven patients were included in this study. Mean cerebral blood flow (CBF) was higher in angiomatous meningiomas. Though mean values of average CBF, maximum, minimum, and SD derived from the ASL MR perfusion were relatively higher in post GKT group as compared to those obtained in pre-GKT but it was not clinically significant. Mean baseline volume of whole cohort was 5.71 cm3 and decreased significantly post GKT in a follow up of 6 months to 5.59 cm3 (P value 0.0018). On comparing volumes of primary and secondary group, volumes were not found be significantly decreased in primary group (P value = 0.1361), 0.1361), but significantly reduced in secondary group (7.13 vs 7.034 cm3) (P value of = 0.0038).
Conclusion:
Our preliminary observations support ASL as a sensitive MRI sequence for the evaluation of meningioma perfusion patterns.
Insights
Arterial spin-labeling (ASL) MRI shows promise in evaluating intracranial meningioma after radiosurgery. While perfusion parameters showed minor changes, tumor volume significantly decreased post-treatment, particularly in secondary meningiomas.
Area of Science:
- Neuroimaging
- Neurosurgery
- Oncology
Background:
- Radiosurgery is a key treatment for intracranial meningiomas.
- Arterial spin-labeling (ASL) is an advanced perfusion MRI technique.
Purpose of the Study:
- To evaluate changes in ASL perfusion parameters in intracranial meningiomas post-radiosurgery.
- To correlate these changes with meningioma histopathological grade.
Main Methods:
- Prospective study of 27 patients with intracranial meningiomas.
- ASL perfusion MRI performed before and 6 months after Gamma Knife radiosurgery (GKT).
Main Results:
- Mean cerebral blood flow (CBF) was higher in angiomatous meningiomas.
- Tumor volume significantly decreased 6 months post-GKT (5.71 cm³ to 5.59 cm³).
- Volume reduction was significant in secondary meningiomas but not primary ones.
Conclusions:
- ASL MRI is a sensitive tool for assessing meningioma perfusion patterns.
- ASL can help evaluate treatment response in intracranial meningiomas.
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