A Clinical Semantic and Radiomics Nomogram for Predicting Brain Invasion in WHO Grade II Meningioma Based on Tumor and Tumor-to-Brain Interface Features

BackgroundBrain invasion in meningioma has independent associations with increased risks of tumor progression, lesion recurrence, and poor prognosis. Therefore, this study aimed to construct a model for predicting brain invasion in WHO grade II meningioma by using preoperative MRI.MethodsOne hundred seventy-three patients with brain invasion and 111 patients without brain invasion were included. Three mainstream features, namely, traditional semantic features and radiomics features from tumor and tumor-to-brain interface regions, were acquired. Predictive models correspondingly constructed on each feature set or joint feature set were constructed.ResultsTraditional semantic findings, e.g., peritumoral edema and other four features, had comparable performance in predicting brain invasion with each radiomics feature set. By taking advantage of semantic features and radiomics features from tumoral and tumor-to-brain interface regions, an integrated nomogram that quantifies the risk factor of each selected feature was constructed and had the best performance in predicting brain invasion (area under the curve values were 0.905 in the training set and 0.895 in the test set).ConclusionsThis study provided a clinically available and promising approach to predict brain invasion in WHO grade II meningiomas by using preoperative MRI.

The tumour volume influence on tumour recurrence and progression-free survival in the case of atypical meningiomas

Objective: The objective of our study was to evaluate a possible relation between the volume of atypical meningiomas (AMs) and the risk of tumour recurrence, as well as progression-free survival (PFS). Material and methods: We evaluated 81 patients diagnosed with AMs (WHO grade II meningioma) who have undergone surgery at the "Prof. Dr. N. Oblu" Emergency Clinical Hospital Iasi between January 1, 2010, and December 31, 2019. The recorded data were demographic and imagistic (MRI, contrast-enhanced T1WI). We calculated the tumour volume prior to the surgery and evaluated the tumour recurrence using MRI at 12, 24, 36, 48 and 60 months after the surgery. Results: 50.6% of patients had meningioma volume < 26.4 cm3. Women had larger tumour volumes than men (52.6%). Patients of age ? 60 years old, had tumour volumes ? 26.4 cm3 in 58.5% of cases and meningiomas with volumes ? 26.4 cm3 recurred earlier (p=0.010). Also, patients who had tumour volumes ? 26.4 cm3, had a shorter PFS (40.976 months), compared to patients with tumour volumes < 26.4 cm3, who had better PFS (53.4 months). Conclusions: the tumour volume of AMs ? 26.4 cm3 represents a negative prognostic factor for both early tumour recurrence and reduced PFS.

Predicting meningioma recurrence using spectrochemical analysis of tissues and subsequent predictive computational algorithms

Introduction Meningioma recurrence remains a clinical dilemma. This has a significant clinical and huge financial implication. Hence, the search for predictors for meningioma recurrence has become an increasingly urgent research topic in recent years. Objective Using spectrochemical analytical methods such as attenuated total reflection Fourier-transform infrared (ATR-FTIR) and Raman spectroscopy, our primary objective is to compare the spectral fingerprint signature of WHO grade I meningioma vs. WHO grade I meningioma that recurred. Secondary objectives compare WHO grade I meningioma vs. WHO grade II meningioma and WHO grade II meningioma vs. WHO grade I meningioma recurrence. Materials and Methods Our selection criteria included convexity meningioma only restricted to Simpson grade I & II only and WHO grade I & grade II only with a minimum 5 years follow up. We obtained tissue from tumour blocks retrieved from the tissue bank. These were sectioned onto slides and de-waxed prior to ATR-FTIR or Raman spectrochemical analysis. Derived spectral datasets were then explored for discriminating features using computational algorithms in the IRootLab toolbox within MATLAB; this allowed for classification and feature extraction. Results After analysing the data using various classification algorithms with cross-validation to avoid over-fitting of the spectral data, we can readily and blindly segregate those meningioma samples that recurred from those that did not recur in the follow-up timeframe. The forward feature extraction classification algorithms generated results that exhibited excellent sensitivity and specificity, especially with spectra obtained following ATR-FTIR spectroscopy. Our secondary objectives remain to be fully developed.

Glioblastoma multiforme as a secondary malignancy following stereotactic radiosurgery of a meningioma: case report

The documentation and exact incidence of stereotactic radiosurgery (SRS)–induced neoplasia is not well understood, with most literature restricted to single case reports and single-center retrospective reviews. The authors present a rare case of radiosurgery-induced glioblastoma multiforme (GBM) following radiosurgical treatment of a meningioma. A 74-year-old patient with a sporadic meningioma underwent radiosurgery following surgical removal of a WHO grade II meningioma. Eighteen months later she presented with seizures, and MRI revealed an intraaxial tumor, which was resected and proven to be a glioblastoma. As far as the authors are aware, this case represents the third case of GBM following SRS for a meningioma. This report serves to increase the awareness of this possible complication following SRS. The possibility of this rare complication should be explained to patients when obtaining their consent for radiosurgery.

Intraindividual comparison of selective intraarterial versus systemic intravenous 68Ga-DOTATATE PET/CT in patients with inoperable meningioma

Aim Here we describe the results of superselective intraarterial application of diagnostic Ga-68-DOTA0,Tyr3-octreotate (Ga-68-DOTATATE) in a series of patients with inoperable WHO grade II meningiomas which were no longer amenable to radiotherapy. Methods Four patients with inoperable WHO grade II meningioma underwent systemic venous infusion of Ga-68-DOTATATE followed by PET/CT. Ga-68-DOTATATE application was repeated intraarterially via transfemoral catheterization of vessels supplying the meningioma and another PET/CT was performed. Results Selective arterial infusion of Ga-68-DOTATATE increased the median value for the maximum standardized uptake value (SUV) by 2.6-fold (median venous: 7.1, median arterial: 21.6; range 2.0–5.0) and the median value for mean SUV by 2.7-fold (median venous: 4.3, median arterial: 11.2; range 1.6–5.6) compared to systemic intravenous infusion. Arterial application was well tolerated by all patients without complications. When compared to liver uptake, intravenous tracer uptake was insufficient for PRRT, whereas tracer uptake after superselective intraarterial tracer injection was sufficient to allow for peptide receptor radionuclide therapy (PRRT) in all patients. Conclusion Insufficient tracer uptake in meningiomas after intravenous application of Ga-68-DOTATATE may be safely increased by a factor of 2–5 using transfemoral selective intraarterial tracer application.