Pedro David Delgado-López, Antonio Montalvo-Afonso, Javier Martín-Alonso, Vicente Martín-Velasco, Rubén Diana-Martín, José Manuel Castilla-Díez
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引用次数: 0
Abstract
Introduction
Predicting the histopathologic grade of meningioma is relevant because local recurrence is significantly greater in WHO grade II–III compared to WHO grade I tumors, which would ideally benefit from a more aggressive surgical strategy. It has been suggested that higher WHO grade tumors are more irregularly-shaped. However, irregularity is a subjective and observer-dependent feature. In this study, the tumor surface irregularity of a large series of meningiomas, measured upon preoperative MRI, is quantified and correlated with the WHO grade.
Methods
Unicentric retrospective observational study of a cohort of symptomatic meningiomas surgically removed in the time period between January 2015 and December 2022. Using specific segmentation software, the surface factor (SF) was calculated for each meningioma. SF is an objective parameter that compares the surface of a sphere (minimum surface area for a given volume) with the same volume of the tumor against the actual surface of the tumor. This ratio varies from 0 to 1, being 1 the maximum sphericity. Since irregularly-shaped meningiomas present proportionally greater surface area, the SF tends to decrease as irregularity increases. SF was correlated with WHO grade and its predictive power was estimated with ROC curve analysis.
Results
A total of 176 patients (64.7% females) were included in the study; 120 WHO grade I (71.9%), 43 WHO grade II (25.7%) and 4 WHO grade III (2.4%). A statistically significant difference was found between the mean SF of WHO grade I and WHO grade II–III tumors (0.8651 ± 0.049 versus 0.7081 ± 0.105, p < 0.0001). Globally, the SF correctly classified more than 90% of cases (area under ROC curve 0.940) with 93.3% sensibility and 80.9% specificity. A cutoff value of 0.79 yielded the maximum precision, with positive and negative predictive powers of 82.6% and 92.6%, respectively. Multivariate analysis yielded SF as an independent prognostic factor of WHO grade.
Conclusion
The surface factor is an objective and quantitative parameter that helps to identify aggressive meningiomas preoperatively. A cutoff value of 0.79 allowed differentiation between WHO grade I and WHO grade II–III with high precision.
期刊介绍:
Neurocirugía is the official Journal of the Spanish Society of Neurosurgery (SENEC). It is published every 2 months (6 issues per year). Neurocirugía will consider for publication, original clinical and experimental scientific works associated with neurosurgery and other related neurological sciences.
All manuscripts are submitted for review by experts in the field (peer review) and are carried out anonymously (double blind). The Journal accepts works written in Spanish or English.