Comparison of ABC/2 estimation and a volumetric computerized method for measurement of meningiomas using magnetic resonance imaging

Opalak, Charles; Parry, Matthew; Rock, Andrew; Sima, Adam P.; Carr, Matthew; Chandra, Vyshak; Workman, Kathryn; Somasundaram, Aravind; Broaddus, William C.

doi:10.1007/s11060-019-03205-z

Cited by 16 publications

(15 citation statements)

References 40 publications

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“…Additionally, due to the historic nature of radiation details, number of fractions and total radiation dose were missing for more than a third of patients. Finally, in this study, we used an approximated method of measuring tumor volume (ABC/2), however this has been externally validated to be a reliable method of measuring tumor volume in meningiomas [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

The growth rate and clinical outcomes of radiation induced meningioma undergoing treatment or active monitoring

et al. 2021

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Introduction Radiation induced meningioma (RIM) incidence is increasing in line with improved childhood cancer survival. No optimal management strategy consensus exists. This study aimed to delineate meningioma growth rates from tumor discovery and correlate with clinical outcomes. Methods Retrospective study of patients with a RIM, managed at a specialist tertiary neuroscience center (2007–2019). Tumor volume was measured from diagnosis and at subsequent interval scans. Meningioma growth rate was determined using a linear mixed-effects model. Clinical outcomes were correlated with growth rates accounting for imaging and clinical prognostic factors. Results Fifty-four patients (110 meningiomas) were included. Median duration of follow-up was 74 months (interquartile range [IQR], 41–102 months). Mean radiation dose was 41 Gy (standard deviation [SD] = 14.9) with a latency period of 34.4 years (SD = 13.7). Median absolute growth rate was 0.62 cm3/year and the median relative growth rate was 72%/year. Forty meningiomas (between 27 patients) underwent surgical intervention after a median follow-up duration of 4 months (IQR 2–35). Operated RIMs were clinically aggressive, likely to be WHO grade 2 at first resection (43.6%) and to progress after surgery (41%). Median time to progression was 28 months (IQR 13–60.5). A larger meningioma at discovery was associated with growth (HR 1.2 [95% CI 1.0–1.5], P = 0.039) but not progression after surgery (HR 2.2 [95% CI 0.7–6.6], P = 0.181). Twenty-seven (50%) patients had multiple meningiomas by the end of the study. Conclusion RIMs exhibit high absolute and relative growth rates after discovery. Surgery is recommended for symptomatic or rapidly growing meningiomas only. Recurrence risk after surgery is high.

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Section: Discussionmentioning

confidence: 99%

The growth rate and clinical outcomes of radiation induced meningioma undergoing treatment or active monitoring

et al. 2021

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“…Briefly, we selected a homogeneous cohort of patients harboring primary glioblastomas (IDH wild type), who were candidates for resective surgery and adjuvant chemo-radiotherapy. Tumor sizes and compartments were determined pre-operatively using the 2D diameter method recommended by the RANO ( 23 , 24 ), the 3D ellipsoid formula ( 25 , 26 ) and the semi-automatic 3D segmentation ( 33 ) methods. Clinical and genetic variables, including gender, age, expression of IDH mutation, and MGMT status, were investigated additionally.…”

Section: Discussionmentioning

confidence: 99%

“…However, the efficacy of the 2D protocol remains currently under debate, particularly, in morphologically irregular tumors ( 22 – 24 ). Almost in parallel, the 3D ellipsoid method, calculating the tumor volume ( 25 , 26 ) and using three orthogonal diameters, was implemented for different tumors, including glioblastoma. However, the irregular shape of most tumors continued to limit accurate volume determinations using this approach ( 24 , 27 ).…”

Section: Introductionmentioning

confidence: 99%

Assessment of Pre-operative Measurements of Tumor Size by MRI Methods as Survival Predictors in Wild Type IDH Glioblastoma

et al. 2020

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Objective: We evaluate the performance of three MRI methods to determine non-invasively tumor size, as overall survival (OS) and Progression Free Survival (PFS) predictors, in a cohort of wild type, IDH negative, glioblastoma patients. Investigated protocols included bidimensional (2D) diameter measurements, and three-dimensional (3D) estimations by the ellipsoid or semi-automatic segmentation methods. Methods: We investigated OS in a cohort of 44 patients diagnosed with wild type IDH glioblastoma (58.2 ± 11.4 years, 1.9/1 male/female) treated with neurosurgical resection followed by adjuvant chemo and radiotherapy. Pre-operative MRI images were evaluated to determine tumor mass area and volume, gadolinium enhancement volume, necrosis volume, and FLAIR-T 2 hyper-intensity area and volume. We implemented then multivariate Cox statistical analysis to select optimal predictors for OS and PFS. Results: Median OS was 16 months (1–42 months), ranging from 9 ± 2.4 months in patients over 65 years, to 18 ± 1.6 months in younger ones. Patients with tumors carrying O 6 -methylguanin-DNA-methyltransferase (MGMT) methylation survived 30 ± 5.2 vs. 13 ± 2.5 months in non-methylated. Our study evidenced high and positive correlations among the results of the three methods to determine tumor size. FLAIR-T 2 hyper-intensity areas (2D) and volumes (3D) were also similar as determined by the three methods. Cox proportional hazards analysis with the 2D and 3D methods indicated that OS was associated to age ≥ 65 years (HR 2.70, 2.94, and 3.16), MGMT methylation (HR 2.98, 3.07, and 2.90), and FLAIR-T 2 ≥ 2,000 mm 2 or ≥60 cm 3 (HR 4.16, 3.93, and 3.72), respectively. Other variables including necrosis, tumor mass, necrosis/tumor ratio, and FLAIR/tumor ratio were not significantly correlated with OS. Conclusion: Our results reveal a high correlation among measurements of tumor size performed with the three methods. Pre-operative FLAIR-T 2 hyperintensity area and volumes provided, independently of the measurement method, the optimal neuroimaging features predicting OS in primary glioblastoma patients, followed by age ≥ 65 years and MGMT methylation.

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“…They acknowledged a significant correlation between the two methods, but the 1/2ABC tended to overestimate tumor volume, particularly for those located in the middle skull base. In a recent publication by Opalak et al, 146 follow-up images of 29 meningiomas were reviewed, and a good correlation between 1/2ABC and planimetry was found; the mean volume difference between methods was 0.2 mL, and the corresponding ICC was 0.95 [ 24 ]. Similarly, in the present study, results showed that 1/2ABC generally correlated well with planimetry.…”

Section: Discussionmentioning

confidence: 99%

Simple Ways to Estimate Meningioma Volume: Can ABC- and SH-Derived Methods Be Used in Clinical Practice Reliably?

Xiao

Liu

et al. 2021

Journal of Oncology

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Background. There is a clinical demand for rapid estimation of meningioma volumes. Our objective was to assess the accuracy of three ABC-derived and three SH-derived formula methods on volume estimation of meningiomas. Methods. The study group comprised 678 patients treated at our department for histopathologically proven intracranial meningiomas. For each patient, tumor volumes were independently measured using six formula methods as well as planimetry. Maximum tumor diameter and ellipsoidity were also recorded. Volumes were compared using descriptive statistics, correlation analysis, and consistency analysis. Results. Among all methods assessed, 2/3SH and 1/2ABC outperformed the others. No significant differences were found between volumes obtained by the two methods and those of planimetry ( p > 0.05 ). Spearman rank-correlation coefficients (rs) were 0.99 for both methods ( p < 0.01 ), and ICC were 0.99 and 0.98, respectively. In Bland-Altman plot, most data points lay inside the limit of agreement. Overall, 2/3SH overestimated tumor volumes by 1.29%, and estimation errors in 93.66% cases were within 20%; 1/2ABC overestimated tumor volumes by 5.36%, and estimation errors in 93.51% cases were within 30%. The performance of 2/3SH and 1/2ABC in small-volume meningiomas was slightly worse, especially for 1/2ABC. Correlations between ellipsoidity and percentage errors of 2/3SH and 1/2ABC were weak (rs = −0.06 and −0.24, respectively). Despite a significant correlation between maximum tumor diameter and planimetric volume (rs = −0.96), volumes could vary significantly for a given diameter. Conclusions. Formula methods 2/3SH and 1/2ABC can estimate meningioma volumes with decent accuracy. Compared with the 1/2ABC method, the 2/3SH method showed slightly better performance, especially in small-volume meningiomas. Ellipsoidity is not a suitable parameter to predict estimation error, and maximum tumor diameter is not a reliable surrogate for actual meningioma volume.

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Comparison of ABC/2 estimation and a volumetric computerized method for measurement of meningiomas using magnetic resonance imaging

Cited by 16 publications

References 40 publications

The growth rate and clinical outcomes of radiation induced meningioma undergoing treatment or active monitoring

The growth rate and clinical outcomes of radiation induced meningioma undergoing treatment or active monitoring

Assessment of Pre-operative Measurements of Tumor Size by MRI Methods as Survival Predictors in Wild Type IDH Glioblastoma

Simple Ways to Estimate Meningioma Volume: Can ABC- and SH-Derived Methods Be Used in Clinical Practice Reliably?

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