MRI predictors for brain invasion in meningiomas

Abstract

Background and purpose In the 2016 revision of the World Health Organization classification of central nervous system tumours, brain invasion was added as an independent histological criterion for the diagnosis of a World Health Organization grade II atypical meningioma. The aim of this study was to assess whether magnetic resonance imaging characteristics can predict brain invasion for meningiomas. Materials and methods We conducted a retrospective review of all meningiomas resected at our institution between 2005 and 2016 which had preoperative magnetic resonance imaging and included brain tissue within the pathology specimen. One hundred meningiomas were included in the study, 60 of which had histopathological brain invasion, 40 of which did not. Magnetic resonance imaging characteristics of tumours were evaluated for potential predictors of brain invasion. Tumour location, size, perilesional oedema, contour, cerebrospinal fluid cleft, peritumoral cyst, dural venous sinus invasion, bone invasion, hyperostosis and the presence of enlarged pial arteries and veins were evaluated. Data were analysed using conventional chi-square, Fisher’s exact test and logistic regression. Results The volume of peritumoral oedema was significantly higher in the brain-invasive meningioma group compared to the non-brain-invasive group. The presence of a complete cleft was a rare finding that was only found in non-brain-invasive meningiomas. The presence of enlarged pial feeding arteries was a rare finding that was only found in brain-invasive meningiomas. Conclusions An increased volume of perilesional oedema is associated with the likelihood of brain invasion for meningiomas.

Nomogram based on MRI can preoperatively predict brain invasion in meningioma

“…In addition, peritumoral oedema was significantly different between the brain invasion and non-invasion groups. After LASSO analysis, there was a strong correlation between peritumoral oedema and brain invasion, which was consistent with the results of previous studies [ 6 , 28 , 30 ]. Several authors have reported a strong correlation between an invasive growth pattern and peritumoral oedema, and Mantle et al found a 20% increase in brain invasion incidence for each centimetre of oedema [ 11 ], while Gill et al reported that every 1-cm 3 increase in peritumoral oedema was associated with a 10% increase in the odds of brain invasion [ 30 ].…”

“…Our result demonstrated that the irregular tumour shape corresponded to an “invasive” phenotype [ 27 ] and tended to grow in all directions at different rates. However, Ong et al reported that brain invasion was not associated with tumour contour [ 28 ]. This discrepancy could be attributed to the sample size.…”

Brain Invasion in Meningioma—A Prognostic Potential Worth Exploring

“…However, only peritumoral edema remained as an independent predictor of brain invasion in the multivariate analysis [41]. The predictive effect of peritumoral edema was later confirmed in other studies [42,43]. Parenchymal edema adjacent to the meningioma interface seems to be an expression of close interaction of the tumor with bordering structures, such as damage to the cortex by an infiltrating tumor.…”

A Clinical Semantic and Radiomics Nomogram for Predicting Brain Invasion in WHO Grade II Meningioma Based on Tumor and Tumor-to-Brain Interface Features

“…Alternatively, in the preoperative diagnosis/assessment, magnetic resonance imaging (MRI) is the most important technique for brain meningioma by taking advantage of its ultra-high tissue resolution and spatial resolution. Previous existing documents suggested that traditional MRI findings, like peri-tumoral edema, heterogeneous contrast enhancement, and irregular tumor shape, have values in predicting brain invasion (6,7). However, the outcomes of these imaging signs are not widely supportive (8), which may be resulting from the limited and insufficient information they provided.…”