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Strand PS, Wågø KJ, Pedersen A, Reinertsen I, Nälsund O, Jakola AS, Bouget D, Hosainey SAM, Sagberg LM, Vanel J, Solheim O. Growth dynamics of untreated meningiomas. Neurooncol Adv 2024; 6:vdad157. [PMID: 38187869 PMCID: PMC10771275 DOI: 10.1093/noajnl/vdad157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Background Knowledge about meningioma growth characteristics is needed for developing biologically rational follow-up routines. In this study of untreated meningiomas followed with repeated magnetic resonance imaging (MRI) scans, we studied growth dynamics and explored potential factors associated with tumor growth. Methods In a single-center cohort study, we included 235 adult patients with radiologically suspected intracranial meningioma and at least 3 MRI scans during follow-up. Tumors were segmented using an automatic algorithm from contrast-enhanced T1 series, and, if needed, manually corrected. Potential meningioma growth curves were statistically compared: linear, exponential, linear radial, or Gompertzian. Factors associated with growth were explored. Results In 235 patients, 1394 MRI scans were carried out in the median 5-year observational period. Of the models tested, a Gompertzian growth curve best described growth dynamics of meningiomas on group level. 59% of the tumors grew, 27% remained stable, and 14% shrunk. Only 13 patients (5%) underwent surgery during the observational period and were excluded after surgery. Tumor size at the time of diagnosis, multifocality, and length of follow-up were associated with tumor growth, whereas age, sex, presence of peritumoral edema, and hyperintense T2-signal were not significant factors. Conclusions Untreated meningiomas follow a Gompertzian growth curve, indicating that increasing and potentially doubling subsequent follow-up intervals between MRIs seems biologically reasonable, instead of fixed time intervals. Tumor size at diagnosis is the strongest predictor of future growth, indicating a potential for longer follow-up intervals for smaller tumors. Although most untreated meningiomas grow, few require surgery.
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Affiliation(s)
- Per Sveino Strand
- Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - André Pedersen
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | - Ingerid Reinertsen
- Department of Health Research, SINTEF Digital, Trondheim, Norway
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Olivia Nälsund
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Asgeir Store Jakola
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - David Bouget
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | | | - Lisa Millgård Sagberg
- Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johanna Vanel
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | - Ole Solheim
- Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Mahgerefteh N, Mozaffari K, Teton Z, Malkhasyan Y, Kim K, Yang I. Incidental Meningiomas: Potential Predictors of Growth and Current State of Management. Neurosurg Clin N Am 2023; 34:347-369. [PMID: 37210125 DOI: 10.1016/j.nec.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The rise in availability of neuroimaging has led to an increase in incidentally discovered meningiomas. These tumors are typically asymptomatic and tend to display slow growth. Treatment options include observation with serial monitoring, radiation, and surgery. Although optimal management is unclear, clinicians recommend a conservative approach, which preserves quality of life and limits unnecessary intervention. Several risk factors have been investigated for their potential utility in the development of prognostic models for risk assessment. Herein, the authors review the current literature on incidental meningiomas, focusing their discussion on potential predictive factors for tumor growth and appropriate management practices.
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Affiliation(s)
- Natalie Mahgerefteh
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Khashayar Mozaffari
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Zoe Teton
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Yelena Malkhasyan
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Kihong Kim
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA
| | - Isaac Yang
- Department of Neurosurgery, University of California, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Department of Radiation Oncology, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Department of Head and Neck Surgery, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Jonsson Comprehensive Cancer Center, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Los Angeles Biomedical Research Institute, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; Harbor-UCLA Medical Center, 300 Stein Plaza, Suite 562, Los Angeles, CA 90095-1761, USA; David Geffen School of Medicine, Los Angeles, 100 West Carson Street, Torrance, CA 90502, USA.
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Kang H, Witanto JN, Pratama K, Lee D, Choi KS, Choi SH, Kim KM, Kim MS, Kim JW, Kim YH, Park SJ, Park CK. Fully Automated MRI Segmentation and Volumetric Measurement of Intracranial Meningioma Using Deep Learning. J Magn Reson Imaging 2023; 57:871-881. [PMID: 35775971 DOI: 10.1002/jmri.28332] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Accurate and rapid measurement of the MRI volume of meningiomas is essential in clinical practice to determine the growth rate of the tumor. Imperfect automation and disappointing performance for small meningiomas of previous automated volumetric tools limit their use in routine clinical practice. PURPOSE To develop and validate a computational model for fully automated meningioma segmentation and volume measurement on contrast-enhanced MRI scans using deep learning. STUDY TYPE Retrospective. POPULATION A total of 659 intracranial meningioma patients (median age, 59.0 years; interquartile range: 53.0-66.0 years) including 554 women and 105 men. FIELD STRENGTH/SEQUENCE The 1.0 T, 1.5 T, and 3.0 T; three-dimensional, T1 -weighted gradient-echo imaging with contrast enhancement. ASSESSMENT The tumors were manually segmented by two neurosurgeons, H.K. and C.-K.P., with 10 and 26 years of clinical experience, respectively, for use as the ground truth. Deep learning models based on U-Net and nnU-Net were trained using 459 subjects and tested for 100 patients from a single institution (internal validation set [IVS]) and 100 patients from other 24 institutions (external validation set [EVS]), respectively. The performance of each model was evaluated with the Sørensen-Dice similarity coefficient (DSC) compared with the ground truth. STATISTICAL TESTS According to the normality of the data distribution verified by the Shapiro-Wilk test, variables with three or more categories were compared by the Kruskal-Wallis test with Dunn's post hoc analysis. RESULTS A two-dimensional (2D) nnU-Net showed the highest median DSCs of 0.922 and 0.893 for the IVS and EVS, respectively. The nnU-Nets achieved superior performance in meningioma segmentation than the U-Nets. The DSCs of the 2D nnU-Net for small meningiomas less than 1 cm3 were 0.769 and 0.780 with the IVS and EVS, respectively. DATA CONCLUSION A fully automated and accurate volumetric measurement tool for meningioma with clinically applicable performance for small meningioma using nnU-Net was developed. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | | | - Kevin Pratama
- Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd, Seoul, Korea
| | - Doohee Lee
- Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd, Seoul, Korea
| | - Kyu Sung Choi
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Min Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Joon Park
- Research and Science Division, Research and Development Center, MEDICALIP Co. Ltd, Seoul, Korea.,Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Millward CP, Keshwara S, Islim AI, Zakaria R, Jenkinson MD. Clinical Presentation and Prognosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1416:5-20. [PMID: 37432616 DOI: 10.1007/978-3-031-29750-2_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
Over the past three decades, the care for patients with meningioma has steadily improved as a result of a better understanding of the natural history, molecular biology, and classification of these tumors. Surgical frameworks for management have been established and validated with more options for adjuvant and salvage treatment available for patients with residual or recurrent disease. Overall these advances have improved clinical outcomes and prognosis.Alongside the improved clinical management has come an increase in biological understanding of these tumors. The number of publications within the field of meningioma research continues to expand and biological studies identifying molecular factors at the cytogenic and genomic level offer exciting potential for more personalized management strategies. As survival and understanding have increased, treatment outcomes are moving from traditional metrics, which describe the morbidity and mortality to more patient-centered measures. The subjective experiences of patients with meningioma are gaining interest among clinical researchers and it is recognized that even supposedly mild symptoms arising from meningioma can have a significant effect on a patient's quality of life.This chapter reviews the varied clinical presentations of meningioma, which in the modern era of widespread brain imaging must include a discussion of incidental meningioma. The second part examines prognosis and the clinical, pathological, and molecular factors that can be used to predict outcomes.
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Affiliation(s)
- Christopher P Millward
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Sumirat Keshwara
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Abdurrahman I Islim
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Rasheed Zakaria
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Michael D Jenkinson
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK.
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Islim AI, Mantziaris G, Pikis S, Chen CJ, Bunevicius A, Peker S, Samanci Y, Nabeel AM, Reda WA, Tawadros SR, El-Shehaby AMN, Abdelkarim K, Emad RM, Delabar V, Mathieu D, Lee CC, Yang HC, Liscak R, May J, Alvarez RM, Moreno NM, Tripathi M, Kondziolka D, Speckter H, Albert C, Bowden GN, Benveniste RJ, Lunsford LD, Sheehan JP, Jenkinson MD. Comparison of Active Surveillance to Stereotactic Radiosurgery for the Management of Patients with an Incidental Frontobasal Meningioma-A Sub-Analysis of the IMPASSE Study. Cancers (Basel) 2022; 14:1300. [PMID: 35267608 PMCID: PMC8909178 DOI: 10.3390/cancers14051300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/26/2022] [Accepted: 02/27/2022] [Indexed: 02/04/2023] Open
Abstract
Meningioma is a common incidental finding, and clinical course varies based on anatomical location. The aim of this sub-analysis of the IMPASSE study was to compare the outcomes of patients with an incidental frontobasal meningioma who underwent active surveillance to those who underwent upfront stereotactic radiosurgery (SRS). Data were retrospectively collected from 14 centres. The active surveillance (n = 28) and SRS (n = 84) cohorts were compared unmatched and matched for age, sex, and duration of follow-up (n = 25 each). The study endpoints included tumor progression, new symptom development, and need for further intervention. Tumor progression occurred in 52.0% and 0% of the matched active surveillance and SRS cohorts, respectively (p < 0.001). Five patients (6.0%) treated with SRS developed treatment related symptoms compared to none in the active monitoring cohort (p = 0.329). No patients in the matched cohorts developed symptoms attributable to treatment. Three patients managed with active surveillance (10.7%, unmatched; 12.0%, matched) underwent an intervention for tumor growth with no persistent side effects after treatment. No patients subject to SRS underwent further treatment. Active monitoring and SRS confer a similarly low risk of symptom development. Upfront treatment with SRS improves imaging-defined tumor control. Active surveillance and SRS are acceptable treatment options for incidental frontobasal meningioma.
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Affiliation(s)
- Abdurrahman I. Islim
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK;
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 7BE, UK
| | - Georgios Mantziaris
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22903, USA; (G.M.); (S.P.); (C.-J.C.); (A.B.); (J.P.S.)
| | - Stylianos Pikis
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22903, USA; (G.M.); (S.P.); (C.-J.C.); (A.B.); (J.P.S.)
| | - Ching-Jen Chen
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22903, USA; (G.M.); (S.P.); (C.-J.C.); (A.B.); (J.P.S.)
| | - Adomas Bunevicius
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22903, USA; (G.M.); (S.P.); (C.-J.C.); (A.B.); (J.P.S.)
| | - Selçuk Peker
- Department of Neurosurgery, Koc University School of Medicine, Istanbul 34010, Turkey; (S.P.); (Y.S.)
| | - Yavuz Samanci
- Department of Neurosurgery, Koc University School of Medicine, Istanbul 34010, Turkey; (S.P.); (Y.S.)
| | - Ahmed M. Nabeel
- Gamma Knife Center Cairo, Nasser Institute, Cairo 11796, Egypt; (A.M.N.); (W.A.R.); (S.R.T.); (A.M.N.E.-S.); (K.A.); (R.M.E.)
- Department of Neurosurgery, Benha University, Benha 13512, Egypt
| | - Wael A. Reda
- Gamma Knife Center Cairo, Nasser Institute, Cairo 11796, Egypt; (A.M.N.); (W.A.R.); (S.R.T.); (A.M.N.E.-S.); (K.A.); (R.M.E.)
- Department of Neurosurgery, Ain Shams University, Cairo 11566, Egypt
| | - Sameh R. Tawadros
- Gamma Knife Center Cairo, Nasser Institute, Cairo 11796, Egypt; (A.M.N.); (W.A.R.); (S.R.T.); (A.M.N.E.-S.); (K.A.); (R.M.E.)
- Department of Neurosurgery, Ain Shams University, Cairo 11566, Egypt
| | - Amr M. N. El-Shehaby
- Gamma Knife Center Cairo, Nasser Institute, Cairo 11796, Egypt; (A.M.N.); (W.A.R.); (S.R.T.); (A.M.N.E.-S.); (K.A.); (R.M.E.)
- Department of Neurosurgery, Ain Shams University, Cairo 11566, Egypt
| | - Khaled Abdelkarim
- Gamma Knife Center Cairo, Nasser Institute, Cairo 11796, Egypt; (A.M.N.); (W.A.R.); (S.R.T.); (A.M.N.E.-S.); (K.A.); (R.M.E.)
- Department of Neurosurgery, Ain Shams University, Cairo 11566, Egypt
| | - Reem M. Emad
- Gamma Knife Center Cairo, Nasser Institute, Cairo 11796, Egypt; (A.M.N.); (W.A.R.); (S.R.T.); (A.M.N.E.-S.); (K.A.); (R.M.E.)
- Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo 12613, Egypt
| | - Violaine Delabar
- Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.D.); (D.M.)
| | - David Mathieu
- Centre de Recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (V.D.); (D.M.)
| | - Cheng-Chia Lee
- Department of Neurosurgery, School of Medicine, Neurological Institute, Taipei Veteran General Hospital, Taipei City 11217, Taiwan; (C.-C.L.); (H.-C.Y.)
- Department of Neurosurgery, National Yang-Ming University, Beitou District, Taipei City 11221, Taiwan
| | - Huai-Che Yang
- Department of Neurosurgery, School of Medicine, Neurological Institute, Taipei Veteran General Hospital, Taipei City 11217, Taiwan; (C.-C.L.); (H.-C.Y.)
- Department of Neurosurgery, National Yang-Ming University, Beitou District, Taipei City 11221, Taiwan
| | - Roman Liscak
- Department of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, 150 00 Prague, Czech Republic; (R.L.); (J.M.)
| | - Jaromir May
- Department of Radiation and Stereotactic Neurosurgery, Na Homolce Hospital, 150 00 Prague, Czech Republic; (R.L.); (J.M.)
| | - Roberto Martinez Alvarez
- Department of Radiosurgery, Rúber International Hospital, 28034 Madrid, Spain; (R.M.A.); (N.M.M.)
| | - Nuria Martinez Moreno
- Department of Radiosurgery, Rúber International Hospital, 28034 Madrid, Spain; (R.M.A.); (N.M.M.)
| | - Manjul Tripathi
- Department of Neurosurgery and Radiotherapy, Nehru Hospital Sector 12, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, Punjab, India;
| | - Douglas Kondziolka
- Department of Neurosurgery, New York University, New York, NY 10016, USA;
- Department of Neurosurgery and Radiation Oncology, New York University, New York, NY 10016, USA
| | - Herwin Speckter
- Department of Radiology, Dominican Gamma Knife Center and CEDIMAT, Santo Domingo 10514, Dominican Republic; (H.S.); (C.A.)
| | - Camilo Albert
- Department of Radiology, Dominican Gamma Knife Center and CEDIMAT, Santo Domingo 10514, Dominican Republic; (H.S.); (C.A.)
| | - Greg N. Bowden
- Department of Neurosurgery, 2D1.02 Mackenzie Health Sciences Centre, University of Alberta, Edmonton, AB T6G 2B7, Canada;
| | - Ronald J. Benveniste
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | | | - Jason P. Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA 22903, USA; (G.M.); (S.P.); (C.-J.C.); (A.B.); (J.P.S.)
| | - Michael D. Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK;
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 7BE, UK
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Abi Jaoude S, Peyre M, Degos V, Goutagny S, Parfait B, Kalamarides M. Validation of a scoring system to evaluate the risk of rapid growth of intracranial meningiomas in neurofibromatosis type 2 patients. J Neurosurg 2021; 134:1377-1385. [PMID: 32442973 DOI: 10.3171/2020.3.jns192382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 03/17/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Intracranial meningiomas occur in about half of neurofibromatosis type 2 (NF2) patients and are very frequently multiple. Thus, estimating individual meningiomas' growth rates is of great interest to tailor therapeutic interventions. The Asan Intracranial Meningioma Scoring System (AIMSS) has recently been published to estimate the risk of tumor growth in sporadic meningiomas. The current study aimed to determine predictors of rapid meningioma growth in NF2 patients and to evaluate the AIMSS score in a specific NF2 cohort. METHODS The authors performed a retrospective analysis of 92 NF2 patients with 358 measured intracranial meningiomas that had been observed prospectively between 2012 and 2018. Tumor volumes were measured at diagnosis and at each follow-up visit. The growth rates were determined and evaluated with respect to the clinicoradiological parameters. Predictors of rapid tumor growth (defined as growth ≥ 2 cm3/yr) were analyzed using univariate followed by multivariate logistic regression to build a dedicated predicting model. Receiver operating characteristic (ROC) curves to predict the risk of rapid tumor growth with the AIMSS versus the authors' multivariate model were compared. RESULTS Sixty tumors (16.76%) showed rapid growth. After multivariate analysis, a larger tumor volume at diagnosis (p < 0.0001), presence of peritumoral edema (p = 0.022), absence of calcifications (p < 0.0001), and hyperintense or isointense signal on T2-weighted MRI (p < 0.005) were statistically significantly associated with rapid tumor growth. It is particularly notable that the genetic severity score did not seem to influence the growth rate of NF2 meningiomas. In comparison with the AIMSS, the authors' multivariate model's prediction did not show a statistically significant difference (area under the curve [AUC] 0.82 [95% CI 0.76-0.88] for the AIMSS vs AUC 0.86 [95% CI 0.81-0.91] for the authors' model, p = 0.1). CONCLUSIONS The AIMSS score is valid in the authors' cohort of NF2-related meningiomas. It adequately predicted risk of rapid meningioma growth and could aid in decision-making in NF2 patients.
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Affiliation(s)
| | - Matthieu Peyre
- 1Department of Neurosurgery and
- 2Sorbonne Universités, Paris
| | - Vincent Degos
- 2Sorbonne Universités, Paris
- 3Neurosurgical Intensive Care, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris
| | - Stéphane Goutagny
- 4Department of Neurosurgery, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris; and
| | - Béatrice Parfait
- 5Department of Genetics and Molecular Biology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, France
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Collin A, Copol C, Pianet V, Colin T, Engelhardt J, Kantor G, Loiseau H, Saut O, Taton B. Spatial mechanistic modeling for prediction of the growth of asymptomatic meningiomas. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 199:105829. [PMID: 33348072 DOI: 10.1016/j.cmpb.2020.105829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/31/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Mathematical modeling of tumor growth draws interest from the medical community as they have the potential to improve patients' care and the use of public health resources. The main objectives of this work are to model the growth of meningiomas - slow-growing benign tumors requiring extended imaging follow-up - and to predict tumor volume and shape at a later desired time using only two times examinations. METHODS We develop two variants of a 3D partial differential system of equations (PDE) which yield after a spatial integration systems of ordinary differential equations (ODE) that relate tumor volume with time. Estimation of models parameters is a crucial step to obtain a personalized model for a patient that can be used for descriptive or predictive purposes. As PDE and ODE systems share the same parameters, they are both estimated by fitting the ODE systems to the tumor volumes obtained from MRI examinations acquired at different times. A population approach allows to compensate for sparse sampling times and measurement uncertainties by constraining the variability of the parameters in the population. RESULTS Description capabilities of the models are investigated in 39 patients with benign asymptomatic meningiomas who had had at least three surveillance MRI examinations. The two models can fit to the data accurately and more realistically than a naive linear regression. Prediction performances are validated for 33 patients using a population approach. Mean relative errors in volume predictions are less than 10% with ODE systems versus 12.5% with the naive linear model using only two times examinations. Concerning the shape, the mean Sørensen-Dice coefficients are 85% with the PDE systems in a subset of 10 representative patients. CONCLUSIONS Our strategy - based on personalization of mathematical model - provides a good insight on meningioma growth and may help decide whether to extend the follow-up or to treat the tumor.
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Affiliation(s)
- Annabelle Collin
- Univ. Bordeaux, Inria Bordeaux-Sud-Ouest, Bordeaux INP, CNRS, IMB, UMR 5251, Talence, F-33400, France.
| | - Cédrick Copol
- Univ. Bordeaux, Inria Bordeaux-Sud-Ouest, Bordeaux INP, CNRS, IMB, UMR 5251, Talence, F-33400, France
| | - Vivien Pianet
- Sophia Genetics, Cité de la Photonique, Pessac, F-33600, France
| | - Thierry Colin
- Sophia Genetics, Cité de la Photonique, Pessac, F-33600, France
| | - Julien Engelhardt
- Service de Neurochirurgie B, Groupe Hospitalier Pellegrin, CHU Bordeaux, Bordeaux, F-33000, France
| | - Guy Kantor
- Département de Radiothérapie, Institut Bergonié, Bordeaux F-33076, France
| | - Hugues Loiseau
- Service de Neurochirurgie B, Groupe Hospitalier Pellegrin, CHU Bordeaux, Bordeaux, F-33000, France; EA 7435 - IMOTION, Univ. Bordeaux, Bordeaux, F-33076, France
| | - Olivier Saut
- Univ. Bordeaux, Inria Bordeaux-Sud-Ouest, Bordeaux INP, CNRS, IMB, UMR 5251, Talence, F-33400, France
| | - Benjamin Taton
- Univ. Bordeaux, Inria Bordeaux-Sud-Ouest, Bordeaux INP, CNRS, IMB, UMR 5251, Talence, F-33400, France; Service de Néphrologie - Transplantation - Dialyse - Aphérèses, Groupe Hospitalier Pellegrin, CHU Bordeaux, Bordeaux, F-33000, France
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Clinical studies of incidental intracranial meningiomas-towards high-quality evidence-based practice. Acta Neurochir (Wien) 2020; 162:671-672. [PMID: 31925541 DOI: 10.1007/s00701-020-04215-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
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Islim AI, Millward CP, Martin-McGill KJ, Kolamunnage-Dona R, Santarius T, Mathew RK, Haylock BJ, Mills SJ, Brodbelt AR, Jenkinson MD. Clinical studies of incidental intracranial meningiomas-towards high-quality evidence-based practice. Acta Neurochir (Wien) 2020; 162:673-674. [PMID: 31938821 DOI: 10.1007/s00701-020-04214-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
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Villanueva-Meyer JE. Modern day imaging of meningiomas. HANDBOOK OF CLINICAL NEUROLOGY 2020; 169:177-191. [PMID: 32553289 DOI: 10.1016/b978-0-12-804280-9.00012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Meningiomas are the most common primary tumors of the central nervous system and as such they are often encountered at neuroimaging. Fortunately, meningiomas are readily diagnosed with anatomic computed tomography and magnetic resonance imaging. While conventional imaging is the mainstay for initial diagnosis and delineating tumor for treatment planning and posttreatment follow-up, the last couple of decades have given rise to advanced physiologic and metabolic imaging techniques that serve as powerful tools in the management of meningioma. These modern approaches are allowing imaging to expand its utility to include extraction of biologic and potentially prognostic information that will ultimately improve care for meningioma patients.
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Affiliation(s)
- Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States.
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