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Multiparametric analysis using MRI after preoperative embolization in meningioma: a preliminary study
Ling Li1, Naoki Ohno1, Mitsuhito Mase2
1Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942, Japan.
Abstract:
Quantitative evaluation of early perfusion and diffusion changes in meningiomas, including both intratumoral region and peritumoral edema, remains limited within the first 1-2 days postembolization. This study aimed to use multiparametric magnetic resonance imaging (MRI) to investigate early structural and perfusion-related changes in both the intratumoral region and peritumoral edema after preoperative embolization of supratentorial meningiomas. Seven patients with supratentorial meningiomas underwent MRI before and 1-2 days after embolization with Embosphere microspheres (100-300 μm and 300-500 μm), primarily via the middle meningeal artery. Quantitative assessments included intratumoral region and peritumoral edema volumes, quantitative T2, and intravoxel incoherent motion (IVIM) parameters (D, f, D*, fD*, and ΔD). In the intratumoral region, significant reductions in volume (mean change of 28.1%, P = 0.028), quantitative T2 (mean change of 7.4%, P = 0.028), and all perfusion-related IVIM parameters (f, D*, fD*) (P ≤ 0.043) were observed. These findings are consistent with early postembolization ischemia. In contrast, the true diffusion coefficient (D) and the dynamic parameter (ΔD) showed no significant change (P > 0.05). Peritumoral edema showed no significant differences across the measured parameters (P > 0.05). Preoperative embolization is associated with early reductions in viable tumor volume, perfusion-related IVIM parameters, and T2, reflecting imaging changes consistent with early ischemia primarily within the intratumoral region. The stability of peritumoral edema parameters suggests that early postembolization effects are mainly limited to the intratumoral region.
Insights
Preoperative embolization of meningiomas causes early ischemic changes within the tumor, shown by reduced volume and perfusion. Peritumoral edema remains unaffected in the early postembolization period.
Area of Science:
- Neuroradiology
- Oncology
- Medical Imaging
Background:
- Quantitative assessment of early changes in meningiomas post-embolization is limited.
- Understanding these early changes is crucial for evaluating treatment effectiveness.
Purpose of the Study:
- To investigate early structural and perfusion changes in supratentorial meningiomas after preoperative embolization using multiparametric MRI.
- To differentiate changes within the intratumoral region from peritumoral edema.
Main Methods:
- Seven patients with supratentorial meningiomas underwent MRI before and 1-2 days after embolization.
- Multiparametric MRI assessed intratumoral and peritumoral edema volumes, quantitative T2, and intravoxel incoherent motion (IVIM) parameters (D, f, D*, fD*, ΔD).
Main Results:
- Significant reductions in intratumoral volume, quantitative T2, and perfusion-related IVIM parameters (f, D*, fD*) were observed post-embolization.
- The true diffusion coefficient (D) and dynamic parameter (ΔD) showed no significant changes.
- Peritumoral edema parameters remained stable, indicating limited early effects beyond the tumor.
Conclusions:
- Preoperative embolization leads to early ischemia within the intratumoral region of meningiomas.
- Early MRI changes reflect reduced viable tumor volume and perfusion, primarily affecting the tumor itself, not the surrounding edema.
