Abstract
Peritumoral brain edema (PTBE) is a common complication in meningioma and disruption of the tumor-brain barrier in meningioma is crucial for PTBE formation. To evaluate the association between meningioma size and PTBE, we measured meningioma volumes using the 3D slicer in patients with convexity and parasagittal meningiomas. Receiver operating characteristic curve analysis was used to determine the optimal cut-off meningioma volume values for predicting PTBE occurrence. Logistic regressions were used to estimate the odds ratios for PTBE occurrence in patients with convexity and parasagittal meningiomas according to several predictive factors. A total of 205 convexity or parasagittal meningioma patients with no other brain disease who underwent one or more contrast-enhanced brain MRIs were enrolled in this 10-year analysis in two hospitals. The optimal cut-off meningioma volume value for prediction of PTBE in all study patients was 13.953 cc (sensitivity = 76.1%; specificity = 92.5%). If a meningioma is assumed to be a complete sphere, 13.953 cc is about 2.987 cm in diameter. Our study suggests a cut-off value of 3 cm meningioma diameter for prediction of PTBE in patients with convexity and parasagittal meningiomas. We believe that we have revealed why the meningioma diameter of 3 cm is clinically meaningful.
Highlights
Meningioma is the second most common intracranial tumor in adults and peritumoral brain edema (PTBE) is a common complication in meningioma patients that causes significant morbidity [1]
A total of 205 convexity or parasagittal meningioma patients with no other brain disease who underwent one or more contrast-enhanced brain MRIs were enrolled in this 10-year analysis in two hospitals
Our study suggests a cut-off value of 3 cm meningioma diameter for prediction of PTBE in patients with convexity and parasagittal meningiomas
Summary
Meningioma is the second most common intracranial tumor in adults and peritumoral brain edema (PTBE) is a common complication in meningioma patients that causes significant morbidity [1]. Various risk factors have been reported which are associated with PTBE formation in meningioma patients that include meningioma size, presence of the tumor-brain barrier, location, tumor margin shape, hyperintensity on T2WI, and vascular endothelial growth factor expression [1,2,3,4]. Tumor-brain barrier disruption in meningioma is crucial for PTBE formation [1]. We recently reported a possible association between PTBE and the brain-meningioma interface and meningioma volume after radiation therapy [7]. If a meningioma is not treated with surgery or radiation, tumor size may be a major factor affecting the integrity of the tumor brain barrier. We wanted to evaluate the pure association between meningioma size and PTBE occurrence without surgery or radiation therapy in patients with meningiomas at similar locations. To evaluate the association between meningioma size and PTBE, we measured meningioma volumes using the 3D slicer in patients with convexity and parasagittal meningiomas
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