A new scoring system for predicting extent of resection in medial sphenoid wing meningiomas based on three-dimensional multimodality fusion imaging

Abstract

Background Three-dimensional (3D) fusion imaging has been proved to be a promising neurosurgical tool for presurgical evaluation of tumor removal. We aim to develop a scoring system based on this new tool to predict the resection grade of medial sphenoid wing meningiomas (mSWM) intuitively. Methods We included 46 patients treated for mSWM from 2014 to 2019 to evaluate their tumors’ location, volume, cavernous sinus involvement, vascular encasement, and bone invasion by 3D multimodality fusion imaging. A scoring system based on the significant parameters detected by statistical analysis was created and evaluated. Results The tumor volumes ranged from 0.8 cm3 to 171.9 cm3. A total of 39 (84.8%) patients had arterial involvement. Cavernous sinus (CS) involvement was observed in 23 patients (50.0%) and bone invasion was noted in 10 patients (21.7%). Simpson I resection was achieved in 10 patients (21.7%) and Simpson II resection was achieved in 17 patients (37.0%). Fifteen patients (32.6%) underwent Simpson III resection and 4 patients (8.7%) underwent Simpson IV resections. A scoring system was created. The score ranged from 1 to 10 and the mean score of our patients was 5.3 ± 2.8. Strong positive monotonic correlation existed between the score and resection grade (Rs = 0.772, P < 0.001). The scoring system had good predictive capacity with an accuracy of 69.60%. Conclusions We described a scoring system that enabled neurosurgeons to predict extent of resection and outcomes for mSWM preoperatively with 3D multimodality fusion imaging. Trial registration Retrospectively registered

Volumetric Analysis of Spheno-Orbital Meningiomas: Prognostic Correlation and a Compartmentalized Approach

“…The current standard practice for describing SOMs involves either a qualitative description of the tumor or a quantitative measurement of the overall tumor volume. 5,21 However, our study suggests that a compartmentalized approach may provide more specific and surgically relevant insight (Figure 5). Surgical intervention for SOM should consistently prioritize achieving gross total resection whenever feasible.…”

Surgery of Meningiomas of the Anterior Clinoid Process

“…The exclusion method is also useful to identify the MAC. All paraoptic meningiomas such as tuberculum sella, diaphragm, cavernous sinus, planum sphenoidale, as well as spheno-orbital are recognizable with their specific findings [6,7,9]. We consider the presence of the anterior clinoid process in the center of the tumor bone attachment to be the main feature of clinoidal meningiomas (Figure 1).…”