Predicting intraoperative meningioma consistency using features from standard MRI sequences: a preoperative...

Area of Science:

• Neurosurgery
• Radiology
• Oncology

Background:

• Symptomatic meningiomas often necessitate surgical resection for neurological preservation or improvement.
• Tumor resection extent is influenced by factors like tumor consistency, location, and patient health.
• Accurate pre-operative assessment of tumor consistency is crucial for surgical planning.

Purpose of the Study:

• To develop a rapid, pre-operative method for characterizing meningioma tumor consistency.
• To combine novel MRI criteria with existing features for improved accuracy.
• To establish a reliable approach for surgical planning based on MRI findings.

Main Methods:

• Prospective study including 48 patients with meningiomas.
• Dedicated MRI protocol performed before surgery.
• Correlation of qualitative and quantitative MRI characteristics with surgical tumor consistency grading.

Main Results:

• Soft tumors showed homogeneous enhancement, high T2 signal, no peritumoral edema (PTE), cysts, and dark fractional anisotropy (FA) maps.
• Firm tumors exhibited heterogeneous enhancement, low T2 signal, PTE, no cysts, and heterogeneous FA maps.
• T2 and Apparent Diffusion Coefficient (ADC) maps moderately correlated with consistency; T1 sequences were not contributory.

Conclusions:

• Simple qualitative MRI characteristics can swiftly differentiate soft from hard meningiomas pre-operatively.
• A figure illustrating these MRI features can aid clinical implementation for surgical planning.
• This approach facilitates optimized surgical strategies for meningioma resection.