Prediction of high-grade meningioma by preoperative MRI assessment


High-grade (World Health Organization grades II and III) meningiomas grow aggressively and recur frequently, resulting in a poor prognosis. Assessment of tumor malignancy before treatment initiation is important. We attempted to determine predictive factors for high-grade meningioma on magnetic resonance (MR) imaging before surgery. We reviewed 65 meningiomas (39 cases, benign; 26 cases, high-grade) and assessed four factors: (1) tumor–brain interface (TBI) on T1-weighted imaging (T1WI), (2) capsular enhancement (CapE), i.e., the layer of the tumor–brain interface on gadolinium-enhanced T1WI (T1Gd), (3) heterogeneity on T1Gd, and (4) tumoral margin on T1Gd. All four factors were useful in distinguishing high-grade from benign meningiomas, according to univariate analysis. On multivariate regression analysis, unclear TBI and heterogeneous enhancement were independent predictive factors for high-grade meningioma. In meningiomas with an unclear TBI and heterogeneous enhancement, the probability of high-grade meningioma was 98%. Our data suggest that this combination of factors obtained from conventional sequences on MR imaging may be useful to predict high-grade meningioma.

DOI: 10.1007/s11060-012-0809-4

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@article{Kawahara2012PredictionOH, title={Prediction of high-grade meningioma by preoperative MRI assessment}, author={Yosuke Kawahara and Mitsutoshi Nakada and Yutaka Hayashi and Yutaka Kai and Yasuhiko Hayashi and Naoyuki Uchiyama and Hiroyuki Nakamura and Jun-ichi Kuratsu and Jun-ichiro Hamada}, journal={Journal of Neuro-Oncology}, year={2012}, volume={108}, pages={147-152} }