Correlation between magnetic resonance imaging grading and pathological grading in meningioma

Abstract

Object This study investigated the specific preoperative MRI features of patients with intracranial meningiomas that correlate with pathological grade and provide appropriate preoperative planning. Methods From 2006 to 2012, 120 patients (36 men and 84 women, age range 20–89 years) with newly diagnosed symptomatic intracranial meningiomas undergoing resection were retrospectively analyzed in terms of radiological features of preoperative MRI. There were 90 WHO Grade I and 30 WHO Grade II or III meningiomas. The relationships between MRI features and WHO histopathological grade were analyzed and scored quantitatively. Results According to the results of multivariate logistic regression analysis, age ≥ 75 years, indistinct tumorbrain interface, positive capsular enhancement, and heterogeneous tumor enhancement were identified factors in the prediction of advanced histopathological grade. The prediction model was quantified as a scoring scale: 2 × (age) + 5 × (tumor-brain interface) + 3 × (capsular enhancement) + 2 × (tumor enhancement). The calculated score correlated positively with the probability of high-grade meningioma. Conclusions This scoring approach may be useful for clinicians in determining therapeutic strategy and in surgical planning for patients with intracranial meningiomas.

The Potential Value of Preoperative MRI Texture and Shape Analysis in Grading Meningiomas: A Preliminary Investigation

“…First, compared with the low-grade cases, the number of high-grade cases was small (21 vs. 110). This data imbalance is similar to previous related studies, and the primary explanation appears to be the relatively low incidence of high-grade meningioma [6], [7], [8], [31]. Second, some degree of selection bias may exist.…”

“…Modern imaging techniques, including traditional MRI, offer an ideal approach for detecting such heterogeneity in a quick, direct, and noninvasive manner. Several studies have sought to determine the correlation between meningioma heterogeneity and histopathological grade [6], [7], [8], [28]. Results of these studies are generally consistent with the view that heterogeneity is a characteristic feature of high-grade meningiomas.…”

“…Several studies have investigated imaging features capable of differentiating between high-grade and low-grade meningiomas, with the most frequently assessed features including tumor heterogeneity, shape, size, and location; tumor-brain interface (TBI); capsular enhancement (CapE); and peritumoral edema [5], [6], [7], [8]. The results indicated that some imaging features, such as tumor heterogeneity, tumor shape, and TBI, had different distributions between high-grade and low-grade meningiomas and hence may be of diagnostic value in grading these tumors.…”

Application of arterial spin labeling perfusion MRI to differentiate benign from malignant intracranial meningiomas

“…Although meningiomas do have some identifiable features on con-ventional MR imaging, no specific feature has been found to be reliable in predicting tumor grade [5,6]. Advanced perfusion MR imaging reflects characteristics of regional tumor angiogenesis and blood supply which is not available by conventional MRI.…”

Meningeal Tumors

“…The dural tail has been shown to occur with lymphoma, peripheral gliomas, and schwannomas. 42,43 Finally, tumor consistency at surgery is related to the difficulty and likelihood of achieving a complete resection, with firmer, more fibrous lesions being more difficult. The specific question of whether the dural tail represents reactive hypervascularity or true tumor infiltration is very critical in planning a strategy for treatment.…”