Peritumoral Brain Edema in Intracranial Meningiomas: Effects of Radiological and Histological Factors

ABSTRACT OBJECTIVE We examined the radiological and histological features influencing the development of peritumoral brain edema (PTBE) among patients with meningiomas. METHODS Factors causing PTBE were retrospectively analyzed for 125 patients with primary intracranial meningiomas. These factors included tumor size, tumor location, brain-tumor interface, signal intensity on T2-weighted scans, contrast enhancement, and cyst formation (as observed on magnetic resonance imaging scans), as well as tumor vascularity and blood supply (as observed in digital subtraction angiography studies). We defined the edema/tumor volume ratio as the edema index, and we used this index to evaluate PTBE. RESULTS A relationship between the tumor size and the volume of PTBE was observed. Convexity and middle fossa meningiomas demonstrated the greatest increases in mean edema indices. Meningothelial, anaplastic, microcystic, and angiomatous subtypes exhibited higher edema indices than did other types. Multivariate analysis demonstrated two significant radiological factors: cortical penetration (as defined by the disappearance of the arachnoid layer on magnetic resonance imaging scans) (relative risk, 2.067;P = 0.0148) and vascular supply from the pial-cortical arteries (as observed on angiograms) (relative risk, 2.087;P = 0.0082). CONCLUSION Tumor infiltration into adjacent brain parenchyma and a pial-cortical blood supply are critical factors for the development of PTBE among patients with meningiomas.

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Peritumoral brain edema in meningiomas: correlations between magnetic resonance imaging, angiography, and pathology

Surgical Neurology ◽

10.1016/j.surneu.2007.03.027 ◽

2008 ◽

Vol 69 (4) ◽

pp. 350-355 ◽

Cited By ~ 48

Author(s):

Kyung-Jin Lee ◽

Won-Il Joo ◽

Hyung-Kyun Rha ◽

Hae-Kwan Park ◽

Jung-Ki Chough ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Brain Edema ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Angiography ◽

Peritumoral Brain Edema

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Imaging of soft tissue tumors

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616666200713183400 ◽

2020 ◽

Vol 16 ◽

Author(s):

Shinji Tsukamoto ◽

Andreas F. Mavrogenis ◽

Yasuhito Tanaka ◽

Costantino Errani

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Soft Tissue ◽

Tumor Size ◽

Critical Role ◽

Evaluation Criteria ◽

Soft Tissue Tumors ◽

Resonance Imaging ◽

Benign Soft Tissue Tumors ◽

Response To Chemotherapy

: Differentiation of malignant from benign soft tissue tumors is challenging with imaging alone, including that by magnetic resonance imaging and computed tomography. However, the accuracy of this differentiation has increased owing to the development of novel imaging technology. Detailed patient history and physical examination remain essential for differentiation between benign and malignant soft tissue tumors. Moreover, measurement only of tumor size based on Response Evaluation Criteria In Solid Tumors criteria is insufficient for the evaluation of response to chemotherapy or radiotherapy. Change in metabolic activity measured by 18F-fluorodeoxyglucose positron emission tomography or dynamic contrast enhanced-derived quantitative endpoints can more accurately evaluate treatment response compared to change in tumor size. Magnetic resonance imaging can accurately evaluate essential factors in surgical planning such as vascular or bone invasion and “tail sign”. Thus, imaging plays a critical role in the diagnosis and treatment of soft tissue tumors.

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The assessment of primary breast cancer tumor size by magnetic resonance imaging, breast ultrasonography and mammography: a comparative study across intrinsic tumor subtype

The Breast ◽

10.1016/s0960-9776(21)00221-6 ◽

2021 ◽

Vol 56 ◽

pp. S71

Author(s):

C.F. Pop ◽

C. Stanciu Pop ◽

S. Drisis ◽

M. Radermeker ◽

C. Vandemerckt ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Comparative Study ◽

Tumor Size ◽

Primary Breast Cancer ◽

Tumor Subtype ◽

Resonance Imaging ◽

Breast Ultrasonography ◽

Cancer Tumor

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The importance of pial blood supply to the development of peritumoral brain edema in meningiomas

Neurosurgical FOCUS ◽

10.3171/foc.1997.2.4.7 ◽

1997 ◽

Vol 2 (4) ◽

pp. E6 ◽

Cited By ~ 1

Author(s):

Michael Bitzer ◽

Lars Wöckel ◽

Andreas R. Luft ◽

Ajay K. Wakhloo ◽

Dirk Petersen ◽

...

Keyword(s):

Brain Edema ◽

Blood Supply ◽

Tumor Size ◽

Tumor Volume ◽

Volume Ratio ◽

Total Tumor Volume ◽

Pial Vessels ◽

Peritumoral Brain Edema ◽

Tumor Region ◽

The Mean

The authors studied the pial and dural blood supplies in 74 intracranial meningiomas and quantified their associated peritumoral brain edema (PTBE). The extent and localization of pial blush in relation to the total tumor volume were determined angiographically. The amount of edema and tumor size were calculated using computerized tomography. The edema-tumor volume ratio was defined as Edema Index (EI). There were 49 meningiomas with PTBE; of those tumors, 46 were supplied by pial vessels, and three were supplied exclusively by dural vessels. Tumors without PTBE showed no pial blush. The mean EI in meningiomas with pial blush was significantly larger (EI = 3.0) than in meningiomas without pial supply (EI = 1.1; p < 0.0001). Meningiomas in which 10% of the whole tumor volume was supplied by pial vessels had only a small mean EI of 2.2, whereas tumors with pial blood supply greater than or equal to 20% had a mean EI of 3.3 (p < 0.026). In 69.9% of cases with pial blood supply, major portions of the edema were located adjacent to the tumor region supplied by pial vessels. Edema index differences among tumors of different subgroups, as defined by size or histology, were significantly related to the pial supply in each subset. Thus, pial blood supply may be causative for the development of PTBE in meningiomas.

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