Volumetric growth of residual meningioma – A systematic review

Meningiomas are the most common primary intracranial neoplasm, accounting for approximately 40% of all primary brain tumors. The incidence of meningioma increases with age to 50 per 100,000 in patients older than 85. As the population ages, an increasing proportion of meningioma patients are elderly. Much of this increase is accounted for by an increase in incidental, asymptomatic diagnoses, which have a low risk of progression in the elderly. The first-line treatment of symptomatic disease is resection. Fractionated radiotherapy (RT) or stereotactic radiosurgery (SRS) can be considered as primary treatment where surgery is not feasible, or as adjuvant therapy in cases of subtotal resection or high grade histopathology. The role of RT/SRS, particularly following gross total resection of atypical meningioma, is unclear and requires further evaluation. There is an increased risk of perioperative and postoperative morbidity in the elderly and therefore management decisions must be tailored to individual circumstances. Good functional outcomes can be achieved in selected patients and age alone is not a contraindication to intervention. The immediate postoperative course is an important determinant of prognosis. Therefore, careful preoperative evaluation and avoidance of complications are necessary to optimize outcomes.

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“… 56 The growth potential of residual meningioma is unclear, but the relative growth rate appears to be less than 15% per annum. 57 …”

Section: Managementmentioning

confidence: 99%

Meningioma in the elderly

Amoo

Henry

Farrell

et al. 2023

Neuro-Oncology Advances

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“…Despite this, there is scarce reporting of volumetric rather than two-dimensional measurements. 6 The slow adoption of volumetric MRI sequences is due to marginally increased acquisition times, increased workload for reporting radiologists and increased incidental findings. The advantages of volumetric studies include increased lesion 1 conspicuity (with more accurate delineation of tumour volume) and co-registration techniques to allow direct comparison.…”

Section: Imaging In the Management Of Intracranial Meningiomamentioning

confidence: 99%

A semi-automatic segmentation method for meningioma developed using a variational approach model

Burrows,

Patel,

Islim

et al. 2023

Neuroradiol J

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Background Meningioma is the commonest primary brain tumour. Volumetric post-contrast magnetic resonance imaging (MRI) is recognised as gold standard for delineation of meningioma volume but is hindered by manual processing times. We aimed to investigate the utility of a model-based variational approach in segmenting meningioma. Methods A database of patients with a meningioma (2007–2015) was queried for patients with a contrast-enhanced volumetric MRI, who had consented to a research tissue biobank. Manual segmentation by a neuroradiologist was performed and results were compared to the mathematical model, using a battery of tests including the Sørensen–Dice coefficient (DICE) and JACCARD index. A publicly available meningioma dataset (708 segmented T1 contrast-enhanced slices) was also used to test the reliability of the model. Results 49 meningioma cases were included. The most common meningioma location was convexity ( n = 15, 30.6%). The mathematical model segmented all but one incidental meningioma, which failed due to the lack of contrast uptake. The median meningioma volume by manual segmentation was 19.0 cm3 (IQR 4.9–31.2). The median meningioma volume using the mathematical model was 16.9 cm3 (IQR 4.6–28.34). The mean DICE score was 0.90 (SD = 0.04). The mean JACCARD index was 0.82 (SD = 0.07). For the publicly available dataset, the mean DICE and JACCARD scores were 0.90 (SD = 0.06) and 0.82 (SD = 0.10), respectively. Conclusions Segmentation of meningioma volume using the proposed mathematical model was possible with accurate results. Application of this model on contrast-enhanced volumetric imaging may help reduce work burden on neuroradiologists with the increasing number in meningioma diagnoses.

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“…The Incidental Meningioma: Prognostic Analysis using patient Comorbidity and MRI Tests (IMPACT) score is a system for using baseline clinical and radiographic features to categorize patients into three distinct prognostic categories. IMPACT can be used to assess risk for future growth and has an online calculator ( ) that is easily used [ 112 , 113 , 114 , 115 , 116 ]. Abnormally quick interval growth (or growth above a pre-determined threshold volume), concerning imaging features suggestive of higher grade, or younger patient age may precipitate treatment in an otherwise asymptomatic patient.…”

Section: Clinical Managementmentioning

confidence: 99%

Clinical Management of Supratentorial Non-Skull Base Meningiomas

Adekanmbi

Youngblood

Karras

et al. 2022

Cancers

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Supratentorial non-skull base meningiomas are the most common primary central nervous system tumor subtype. An understanding of their pathophysiology, imaging characteristics, and clinical management options will prove of substantial value to the multi-disciplinary team which may be involved in their care. Extensive review of the broad literature on the topic is conducted. Narrowing the scope to meningiomas located in the supratentorial non-skull base anatomic location highlights nuances specific to this tumor subtype. Advances in our understanding of the natural history of the disease and how findings from both molecular pathology and neuroimaging have impacted our understanding are discussed. Clinical management and the rationale underlying specific approaches including observation, surgery, radiation, and investigational systemic therapies is covered in detail. Future directions for probable advances in the near and intermediate term are reviewed.

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Volumetric growth of residual meningioma – A systematic review

Cited by 6 publications

References 27 publications

Meningioma in the elderly

Meningioma in the elderly

A semi-automatic segmentation method for meningioma developed using a variational approach model

Clinical Management of Supratentorial Non-Skull Base Meningiomas

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