Features of tumor texture influence surgery and outcome in intracranial meningioma

Abstract

Objective Texture-related factors such as consistency, vascularity and adherence vary considerably in meningioma and are thought to be linked with surgical resectibility and morbidity. However, data analyzing the true impact of menigioma texture on the surgical management is sparse Methods Patients with intracranial meningioma treated between 08/2014-04/2018 at our institution were prospectively collected for demographics, clinical presentation, histology and surgical treatment with related morbidity and extend of resection (EOR). Tumor characteristics were reported by the surgeon using a standardized questionnaire including items such as tumor consistency, homogeneity, vascularization and adherence to surrounding neurovascular structure and analyzed for their impact surgical outcome parameters using univariate and logistic regression analyses Results Tumor-texture related parameters of 300 patients (72.3% female) with meningioma were analyzed. Meningioma localizations were grouped into 3 different cohorts namely convexity, skull base and posterior. Postoperativ occurrence of a neurological deficit (transient 23.0%; permanent 6.1%) was associated with the duration of surgery (p=0.001), size of tumor (p=0.046), tumor vascularization (p=0.015) and adherence to neurovascular structures (p=0.002). Coherently, the duration of surgery (mean 230.99 ± 101.33 min) was associated with size of tumor (p<0.0001), vascularization (p<0.0001) and adherence (p<0.0001). Similar associations were recapitulated in subgroup analyses of different tumor localizations. Noteworthy, tumor rigidity had no significant impact on time of surgery and neurological outcome Conclusions Our analysis demontrates that tumor texture has an impact on the surgical management of meningioma and provides data that tumor vascularization and adherence are significant factors influencing surgical outcome whereas the influence of tumor consistency has less impact than previously thought

Variability in the Arterial Supply of Intracranial Meningiomas: An Anatomic Study

“…Highly vascularized meningiomas pose a different set of challenges to the neurosurgeon than less vascular tumors. 29 We found that larger tumors and the presence of PTBE were significantly associated with the number of arterial feeders. The average number of feeding vessels did not differ between skull base and NSBM in our study.…”

Presurgical MRI‐Based Radiomics Models for Predicting Cerebellar Mutism Syndrome in Children With Posterior Fossa Tumors

“…Texture characteristics might imply the toughness of operations. 40 Consequently, radiomics could be used to predict CMS. Owing to the lack of similar studies, the further underlying mechanisms between these radiomics features and CMS are unclear, and need to be validated in future studies.…”

“…Invasiveness reflects the extent how brain tissue is infiltrated by the tumor. Texture characteristics might imply the toughness of operations 40 . Consequently, radiomics could be used to predict CMS.…”

Spinal meningiomas

“…Tumor texture can influence surgical morbidity and outcome as recently shown for intracranial meningiomas. 48 Based on imaging characteristics and growth patterns, SM can usually be differentiated from other intradural extramedullary spinal cord lesions such as neurofibroma and schwannoma. Signal intensity ratio of the spinal tumor and fat on T2 weighted images is useful for differentiating schwannomas from meningiomas to obtain an accurate diagnosis.…”