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Ren L, Hua L, Bao Z, Deng J, Wang D, Chen J, Chen H, Juratli TA, Wakimoto H, Gong Y. Distinct clinical outcome of microcystic meningioma as a WHO grade 1 meningioma subtype. J Neurooncol 2023; 161:193-202. [PMID: 35612696 DOI: 10.1007/s11060-022-04034-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the clinicopathological characteristics, radiology, and long-term outcomes of microcystic meningiomas (MM) and compare it with other subtypes of meningiomas managed at a single neurosurgical center. METHODS A total of 87 consecutive patients who underwent surgical resection and were diagnosed as MM between 2005 and 2016 were enrolled for analysis. Clinicopathological, radiology, and prognostic information was collected and analyzed. Progression free survival (PFS) was compared with 659 patients with other subtypes of WHO grade 1 meningiomas and 167 patients with atypical meningiomas treated during the same period. RESULTS Fifty six females and 31 males with MM were analyzed. Peri-tumor brain edema was frequent on T2 WI (85%).12 patients (13.8%) experienced tumor progression during the mean follow-up of 101.66 ± 40.92 months. The median PFS was unavailable, and the 5, 10, and 15 year progression-free rates were 96.9%, 84.0%, and 73.9%, respectively. Univariate COX analysis demonstrated skull base location and higher Ki-67 index as significant negative prognostic factors for PFS (P < 0.05); multivariate analysis identified tumor location and Ki-67 index as independent factors (P < 0.01), as well. Of note, the PFS of MM was worse than other WHO grade 1 subtypes (P < 0.001), but better than atypical meningiomas (P < 0.001), and the PFS differences were retained even when the analysis was limited to the patients receiving GTR (P < 0.05). CONCLUSION The PFS of MM was worse than other WHO grade 1 subtypes and better than atypical meningiomas. Skull base location and higher Ki-67 index were independent negative prognostic factors in MM.
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Affiliation(s)
- Leihao Ren
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Lingyang Hua
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Zhongyuan Bao
- Department of Neurosurgery, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, China
| | - Jiaojiao Deng
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Daijun Wang
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Jiawei Chen
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China
| | - Hong Chen
- Department of Pathology, Shanghai Medical College, Huashan Hospital, Fudan University, Shanghai, China
| | - Tareq A Juratli
- Department of Neurosurgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Hiroaki Wakimoto
- Department of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Ye Gong
- Department of Neurosurgery, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China. .,Institute of Neurosurgery, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China. .,Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China. .,Department of Critical Care Medicine, Shanghai Medical College, Huashan Hospital, Fudan University, 12# Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.
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Liu X, Huang X, Han T, Li S, Xue C, Deng J, Zhou Q, Sun Q, Zhou J. Discrimination between microcystic meningioma and atypical meningioma using whole-lesion apparent diffusion coefficient histogram analysis. Clin Radiol 2022; 77:864-869. [PMID: 36030110 DOI: 10.1016/j.crad.2022.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 11/03/2022]
Abstract
AIM To explore the value of whole-lesion apparent diffusion coefficient (ADC) histogram analysis in discriminating microcystic meningioma (MCM) from atypical meningioma (AM). MATERIALS AND METHODS Clinical and preoperative MRI data of 20 patients with MCM and 26 patients with AM were analysed retrospectively. Whole-lesion apparent diffusion coefficient (ADC) histogram analysis was performed on each patient's lesion to obtain histogram parameters, including mean, variance, skewness, kurtosis, the 1st (ADCp1), 10th (ADCp10), 50th (ADCp50), 90th (ADCp90), and 99th (ADCp99) percentiles of ADC. The differences between the ADC histogram parameters of the two tumours were compared, and the receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of statistically significant parameters in distinguishing the two tumours. RESULTS The mean, ADCp1, ADCp10, ADCp50, and ADCp90 of MCM were greater than those of AM, and significant differences were observed in these parameters between MCM and AM (all p<0.05). ROC analysis showed that the mean had the highest area under the curve value (AUC) in distinguishing the two tumours (AUC = 0.852), when using 120.46 × 10-6 mm2/s as the optimal threshold, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for discriminating the two groups were 84.6%, 75%, 80.4%, 81.5%, and 78.9%, respectively. CONCLUSION Histogram analysis based on whole-lesion ADC maps was useful for discriminating between MCM from AM preoperatively, with the mean being the most promising potential parameter.
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Affiliation(s)
- X Liu
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - X Huang
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - T Han
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - S Li
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - C Xue
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - J Deng
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Q Zhou
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - Q Sun
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China
| | - J Zhou
- Radiology of Department, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou 730030, People's Republic of China; Second Clinical School, Lanzhou University, Lanzhou, People's Republic of China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, People's Republic of China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, People's Republic of China.
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