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Gadolinium-enhanced MR in the evaluation of preoperative meningioma embolization
C Grand1, W O Bank, D Balériaux
1Department of Neuroradiology, Hôpital Universitaire Erasme, Université Libre de Bruxelles, Belgium.
Purpose:
To evaluate the use of postembolization gadolinium-enhanced MR imaging as a means to judge the efficacy of tumor embolization.
Methods:
Fifteen patients with meningiomas were prospectively studied. The following data were evaluated for each tumor: the percentage of vascular supply to the tumor arising from the internal and external carotid arteries; the percentage of the tumor embolized as judged by angiography, by MR imaging, and by CT scanning; the estimated blood loss according to the surgeon; and histologic evidence of necrosis as seen by the neuropathologist.
Results:
The data reveal an excellent correlation between the amount of tumor embolized as estimated by MR and both the estimated blood loss at time of surgery and the presence of histological necrosis in the specimen.
Conclusions:
Postembolization gadolinium-enhanced MR is an excellent means to evaluate the efficacy of an embolization and offers certain advantages over CT and angiography. One important advantage of this technique lies in the fact that it can be performed immediately postembolization.
Insights
Postembolization gadolinium-enhanced MRI effectively assesses tumor embolization success, correlating well with reduced blood loss and histological necrosis. This imaging technique offers advantages over CT and angiography for evaluating embolization efficacy.
Area of Science:
- Radiology
- Oncology
- Neurosurgery
Background:
- Tumor embolization is a critical procedure for treating various neoplasms, including meningiomas.
- Accurate post-procedure assessment is vital to confirm treatment efficacy and guide further management.
- Conventional imaging modalities like CT and angiography have limitations in evaluating embolization completeness.
Purpose of the Study:
- To determine the utility of postembolization gadolinium-enhanced Magnetic Resonance (MR) imaging in assessing the success of tumor embolization.
- To compare the efficacy of MR imaging with traditional methods like CT and angiography.
Main Methods:
- A prospective study involving fifteen patients with meningiomas undergoing embolization.
- Evaluation of tumor vascular supply from internal and external carotid arteries.
- Quantification of embolized tumor volume using angiography, MR imaging, and CT scanning.
- Correlation with estimated blood loss during surgery and histological evidence of tumor necrosis.
Main Results:
- Postembolization gadolinium-enhanced MR imaging demonstrated an excellent correlation with the extent of tumor embolization.
- MR imaging findings showed a strong association with reduced estimated blood loss during surgery.
- A significant correlation was observed between MR imaging results and the presence of histological necrosis.
Conclusions:
- Postembolization gadolinium-enhanced MR imaging is a highly effective tool for evaluating the success of tumor embolization.
- This MR technique offers advantages over CT and angiography, including immediate post-procedure assessment.
- Gadolinium-enhanced MR imaging provides a reliable and rapid method for judging embolization efficacy.