Predicting the risk of postoperative recurrence and high-grade histology in patients with intracranial meningiomas using routine preoperative MRI

AbstractRisk factors for prediction of prognosis in meningiomas derivable from routine preoperative magnetic resonance imaging (pMRI) remain elusive. Correlations of tumor and edema volume, disruption of the arachnoid layer, heterogeneity of contrast enhancement, enhancement of the capsule, T2-intensity, tumor shape, and calcifications on pMRI with tumor recurrence and high-grade (WHO grade II/III) histology were analyzed in 565 patients who underwent surgery for WHO grade I (N = 516, 91%) or II/III (high-grade histology,N = 49, 9%) meningioma between 1991 and 2018. Edema volume (OR, 1.00;p = 0.003), heterogeneous contrast enhancement (OR, 3.10;p <  0.001), and an irregular shape (OR, 2.16;p = 0.015) were associated with high-grade histology. Multivariate analyses confirmed edema volume (OR, 1.00;p = 0.037) and heterogeneous contrast enhancement (OR, 2.51;p = 0.014) as risk factors for high-grade histology. Tumor volume (HR, 1.01;p = 0.045), disruption of the arachnoid layer (HR, 2.50;p = 0.003), heterogeneous contrast enhancement (HR, 2.05;p = 0.007), and an irregular tumor shape (HR, 2.57;p = 0.001) were correlated with recurrence. Multivariate analyses confirmed tumor volume (HR, 1.01;p = 0.032) and disruption of the arachnoid layer (HR, 2.44;p = 0.013) as risk factors for recurrence, independent of histology. Subgroup analyses revealed disruption of the arachnoid layer (HR, 9.41;p <  0.001) as a stronger risk f...
Source: Neurosurgical Review - Category: Neurosurgery Source Type: research