A practical predictor of the growth potential of benign meningiomas: Hypointensity of surface layer in T2-weighted magnetic resonance imaging.


Journal

Clinical imaging
ISSN: 1873-4499
Titre abrégé: Clin Imaging
Pays: United States
ID NLM: 8911831

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 19 07 2019
revised: 03 12 2019
accepted: 07 01 2020
pubmed: 6 2 2020
medline: 4 9 2020
entrez: 5 2 2020
Statut: ppublish

Résumé

Accurate evaluation of proliferative potential is particularly important in the clinical management of individual patients with meningiomas. We introduce a new feature in the parenchyma of meningioma, namely, hypointensity of the surface layer (HSL), on T2-weighted MR images and compare it with a cellular proliferation index and growth speed. We retrospectively analyzed the records of consecutive patients with WHO grade I meningiomas in two institutes: an operated group with 124 meningiomas resected in one institute, and an observed group with 89 meningiomas monitored without surgery in the other. Proliferative potential was evaluated using the MIB-1 labeling index (MIB-1 LI) for the operated group and using the relative growth rate on serial MR images for the observed group. In the operated group, 60 (48.4%) meningiomas exhibited HSL. HSL-positive meningiomas were significantly smaller in size and more often calcified than HSL-negative ones. Univariate analysis showed that HSL negativity, large size, no calcification, and surrounding brain edema were significantly associated with high MIB-1 LI (p < 0.05). Multivariate analysis demonstrated that only HSL was significantly related to MIB-1 LI (p = 0.001). HSL did not correlate with tumor recurrence after resection. In the observed group, 43 (48.3%) meningiomas exhibited HSL and they presented a significantly slow relative growth rate. HSL is a simple and new radiological feature indicative of low proliferative potential and a low risk of enlargement of meningiomas. The presence or absence of HSL may serve as a key parameter for the selection of aggressive treatment or active observation.

Sections du résumé

BACKGROUND BACKGROUND
Accurate evaluation of proliferative potential is particularly important in the clinical management of individual patients with meningiomas. We introduce a new feature in the parenchyma of meningioma, namely, hypointensity of the surface layer (HSL), on T2-weighted MR images and compare it with a cellular proliferation index and growth speed.
MATERIALS AND METHODS METHODS
We retrospectively analyzed the records of consecutive patients with WHO grade I meningiomas in two institutes: an operated group with 124 meningiomas resected in one institute, and an observed group with 89 meningiomas monitored without surgery in the other. Proliferative potential was evaluated using the MIB-1 labeling index (MIB-1 LI) for the operated group and using the relative growth rate on serial MR images for the observed group.
RESULTS RESULTS
In the operated group, 60 (48.4%) meningiomas exhibited HSL. HSL-positive meningiomas were significantly smaller in size and more often calcified than HSL-negative ones. Univariate analysis showed that HSL negativity, large size, no calcification, and surrounding brain edema were significantly associated with high MIB-1 LI (p < 0.05). Multivariate analysis demonstrated that only HSL was significantly related to MIB-1 LI (p = 0.001). HSL did not correlate with tumor recurrence after resection. In the observed group, 43 (48.3%) meningiomas exhibited HSL and they presented a significantly slow relative growth rate.
CONCLUSIONS CONCLUSIONS
HSL is a simple and new radiological feature indicative of low proliferative potential and a low risk of enlargement of meningiomas. The presence or absence of HSL may serve as a key parameter for the selection of aggressive treatment or active observation.

Identifiants

pubmed: 32018148
pii: S0899-7071(20)30020-6
doi: 10.1016/j.clinimag.2020.01.009
pii:
doi:

Substances chimiques

Ki-67 Antigen 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

10-16

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no conflicts of interest.

Auteurs

Shoichi Deguchi (S)

Divisions of Neurosurgery, Shizuoka Cancer Center, Nagaizumi-cho, Shizuoka, Japan. Electronic address: s.deguchi@scchr.jp.

Kazuaki Nakashima (K)

Diagnostic Radiology, Shizuoka Cancer Center, Nagaizumi-cho, Shizuoka, Japan.

Yoko Nakasu (Y)

Divisions of Neurosurgery, Shizuoka Cancer Center, Nagaizumi-cho, Shizuoka, Japan.

Koichi Mitsuya (K)

Divisions of Neurosurgery, Shizuoka Cancer Center, Nagaizumi-cho, Shizuoka, Japan.

Nakamasa Hayashi (N)

Divisions of Neurosurgery, Shizuoka Cancer Center, Nagaizumi-cho, Shizuoka, Japan.

Ichiro Ito (I)

Diagnostic Pathology, Shizuoka Cancer Center, Nagaizumi-cho, Shizuoka, Japan.

Masahiro Endo (M)

Diagnostic Radiology, Shizuoka Cancer Center, Nagaizumi-cho, Shizuoka, Japan.

Sawako Kitahara (S)

Divisions of Clinical Radiology, Kusatsu General Hospital, Kusatsu, Shiga, Japan.

Satoshi Nakasu (S)

Neurosurgery, Kusatsu General Hospital, Kusatsu, Shiga, Japan.

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Classifications MeSH