Treatment Outcomes of Incidental Intracranial Meningiomas: Results from the IMPACT Cohort

Islim, Abdurrahman I; Mohan, Midhun; Moon, Richard; Rathi, Nitika; Kolamunnage‐Dona, Ruwanthi; Crofton, Anna; Haylock, Brian; Mills, Samantha J.; Brodbelt, Andrew; Jenkinson, Michael D.

doi:10.1016/j.wneu.2020.03.060

Cited by 22 publications

(12 citation statements)

References 36 publications

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“…Even though the subgroup of patients in this study that were investigated after the start of lockdown was small, no considerable difference between responses were noticeable. According to a retrospective cohort of patients diagnosed with an incidental intracranial meningioma, approximately 10% underwent treatment within 8 years, and in a third of these patients, the indication was solely patient preference [ 11 ]. In our study, the level of distress was similar between patients that were diagnosed or operated on meningioma within a year vs. patients who were followed up for a longer period of time.…”

Section: Discussionmentioning

confidence: 99%

Distress and quality of life do not change over time in patients with operated and conservatively managed intracranial meningioma

et al. 2021

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Purpose The patients’ burden with asymptomatic meningiomas and patients with good clinical outcome after meningioma resection often remains neglected. In this study, we aimed to investigate the longitudinal changes of psychological distress and quality of life in these patient groups. Methods Patients with conservatively managed (CM) or operated (OM) meningiomas and excellent neurological status, who were screened for psychological distress during the follow-up visit (t1), were included. We performed a follow-up mail/telephone-based survey 3–6 months (t2) after t1. Distress was measured using Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), 36-item Short Form (SF-36), and Brief Fatigue Inventory (BFI). Results Sixty-two patients participated in t1 and 47 in t2. The number of patients reporting increased or borderline values remained high 3 months after initial presentation, with n = 25 (53%) of patients reporting increased anxiety symptom severity and n = 29 (62%) reporting increased depressive symptom severity values. The proportion of distressed patients according to a DT score remained similar after 3 months. Forty-four percent of patients reported significant distress in OM and 33% in CM group. The most common problems among distressed patients were fatigue (t2 75%) and worries (t2 50%), followed by pain, sleep disturbances, sadness, and nervousness. Tumor progress was associated with increased depression scores (OR 6.3 (1.1–36.7)). Conclusion The level of psychological distress in asymptomatic meningiomas and postoperative meningiomas with excellent outcome is high. Further investigations are needed to identify and counsel the patients at risk.

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Section: Discussionmentioning

confidence: 99%

Distress and quality of life do not change over time in patients with operated and conservatively managed intracranial meningioma

et al. 2021

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“…2,3 However, meningiomas are commonly diagnosed incidentally, and preferred management of asymptomatic meningiomas without imaging evidence of mass effect is by observation. 3,4 The standard of care for meningioma imaging surveillance is with contrast-enhanced MRI using gadolinium-based contrast agents (GBCAs). 5,6 The risk of chronic GBCA exposure is currently unknown.…”

Section: Introductionmentioning

confidence: 99%

“…1 Some meningiomas are symptomatic and are managed with surgery, radiation, or medical therapy. 2,3 However, meningiomas are commonly diagnosed incidentally, and preferred management of asymptomatic meningiomas without imaging evidence of mass effect is by observation. 3,4 The standard of care for meningioma imaging surveillance is with contrast-enhanced MRI using gadolinium-based contrast agents (GBCAs).…”

Section: Introductionmentioning

confidence: 99%

“…Meningiomas are the most common nonmalignant intracranial tumors, with over 150,000 diagnosed cases in the United States between 2012 and 2016 1 . Some meningiomas are symptomatic and are managed with surgery, radiation, or medical therapy 2,3 . However, meningiomas are commonly diagnosed incidentally, and preferred management of asymptomatic meningiomas without imaging evidence of mass effect is by observation 3,4 .…”

Section: Introductionmentioning

confidence: 99%

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Intracranial meningioma surveillance using volumetrics from T2‐weighted MRI

Raban

Patel

Honce

et al. 2021

Journal of Neuroimaging

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Background and Purpose:The gold standard for imaging of meningiomas is MRI with gadolinium-based contrast agent. Due to increased costs, time, and uncertain chronic effects of gadolinium exposure, use of noncontrast T2-weighted imaging (T2WI) in lieu of contrast-enhanced MRI has been an increasing focus of research across various diagnostic scenarios. The purpose of this study was to evaluate the diagnostic accuracy of T2WI in detecting changes in meningioma tumor volume. Methods: Imaging and clinical data were reviewed for 82 consecutive patients undergoing MR-surveillance of intracranial meningioma. Using volumetric-T2WI, two neuroradiologists independently calculated tumor volumes. Measurements were compared to a baseline study contrast-enhanced T1 tumor volume. Using contrast-enhanced sequences as the reference standard, statistical analysis was performed to determine the accuracy of T2WI in detecting changes of meningioma volume. Results: Using only T2WI, readers detected meningioma volume change ≥ 20% in 19/82 patients and volume change <20% in 63/82 patients. Reader accuracy for detecting change in tumor volume on T2WI ≥ 20% was 0.85, sensitivity 0.65, specificity 0.93, positive predictive value (PPV) 0.79, and negative predictive value (NPV) 0.87. For meningiomas >1 ml, reader accuracy for detecting change in tumor volume on T2WI ≥20% was 0.90, sensitivity 0.78, specificity 0.95, PPV 0.88, and NPV 0.91. Change in tumor volume on T2WI ≥20% was detected with 100% accuracy for posterior fossa meningiomas. Interreader agreement for all meningiomas was moderate (κ = 0.45) improving to substantial agreement (κ = 0.77) with tumor volumes >1 ml. Conclusion: Volumetric-T2WI detects changes in meningioma volume with comparable accuracy to gold standard T1 postcontrast imaging, particularly with higher tumor volumes and posterior fossa locations.

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“…Three World Health Organization (WHO) grades with 15 histological subtypes have been included in the WHO classifi cation scheme which underscores the heterogeneity in clinical and molecular characteristics of meningiomas [1,3,6].…”

Section: Introductionmentioning

confidence: 99%

Multimodality management of cavernous sinus meningiomas with less extensive surgery followed by subsequent irradiation: Implications for an improved toxicity profile

Sager¹,

Beyzadeoğlu²,

Dincoglan³

et al. 2020

J Surg Surgical Res

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Treatment Outcomes of Incidental Intracranial Meningiomas: Results from the IMPACT Cohort

Cited by 22 publications

References 36 publications

Distress and quality of life do not change over time in patients with operated and conservatively managed intracranial meningioma

Distress and quality of life do not change over time in patients with operated and conservatively managed intracranial meningioma

Intracranial meningioma surveillance using volumetrics from T2‐weighted MRI

Multimodality management of cavernous sinus meningiomas with less extensive surgery followed by subsequent irradiation: Implications for an improved toxicity profile

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