Abstract
BACKGROUND: The natural history of surgically treated intracranial meningiomas can be quite variable. Recurrence and patient outcome cannot currently be predicted with accuracy. We explore the correlation of volumetric tumor measurement on preoperative imaging with measures of proliferation and angiogenesis. METHODS: We examined preoperative imaging and tissue from 263 patients with an average follow-up 90 months. Tumor size was obtained by two methods. The first by estimation using measures of maximal diameter in three planes and multiply these measure using the formula length X width X height X 0.5. The second method was by volumetric measures using OSRIX software. Tissue was examined for measures proliferation (MIB-1); and three methods of computer assisted measures of microvascular density (MVD) using antibodies for Factor VIII, CD 31 and CD 105. RESULTS: There is high correlation between tumor volume measured by the cross sectional diameter measures and volumetric measures. Both are positively correlated with MIB-1 measurement (p = 0.011). In a similar manner, higher tumor volumes are associated with higher MVD measures (p = 0.037). We also found a correlation between the three methods of MVD measurements but comparison of the accuracy of methods still needs to be examined. Progression-free survival (PFS) was associated with higher grade (p < 0.001), MIB-labeling index (p < 0.001) on pairwise comparisons. Using multivariate analysis, PFS was associated with MIB-labeling index (HR 1.68, p = 0.005). Shorter overall survival was associated with MIB-labeling index (HR 1.87, p < 0.001) when controlled for age. CONCLUSION: MIB-1 and MVD measures correlate with tumor volume measured by a two methods. With further refinement these molecular markers may be used to predict outcome for patients with intracranial meningiomas.
Accepted Version
Published Version
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