Neuroimaging features of intracranial meningiomas recurrence and progression

INTRODUCTION. Meningiomas occur in 18–34 % of cases of all intracranial neoplasms in adults. Intracranial meningiomas recurrence and progression occurs, on average, in 25 % of patients, even after radical tumor removal and radiotherapy, which significantly worsens the prognosis and functional outcome.

PURPOSE. To describe the neuroimaging features picture in patients with Intracranial meningiomas recurrence and progression, to show the capabilities of modern diagnostic methods (MRI, MR perfusion, PET-CT) in assessing the progression in meningiomas.

MATERIALS AND METHODS. The basis of the study consisted of patients (n=105) with intracranial meningiomas recurrence and progression Grade I–III, treated in the Department of Neurosurgery No. 4 of the Russian Neurosurgical Institute named after. prof. A.L. Polenov in the period from 2014 to 2022. An analysis of intrascopic data in patients with recurrence and progression of meningiomas was carried out. Tumors were characterized by volume, contours, the presence of perifocal edema and the degree of its severity with analysis in DWI mode (ICD) and assessment of MR perfusion parameters (ASL-perfusion), severity and type of contrast, the presence of a border with normal brain and assessment of additional signs (“comet tail”, hyperostosis, erosion of adjacent bone, extracranial spread, sinus invasion). The PET/CT procedure was performed on a combined system for positron emission and X-ray computed tomography. In case of tumor recurrence, its localization and direction of growth were also assessed. During the study, the results obtained were processed by the STATISTICA 10.0 software system.

RESULTS. Introscopy data for recurrent intracranial meningiomas were analyzed, the main trends in the oncogenesis were identified, and the most common diagnostic features of tumor progression were identified, which need to be taken into account for planning surgery and treatment tactics.

CONCLUSION. In diagnosing recurrence and progression of intracranial meningiomas it is important to examine patients comprehensively, using the modern research methods of neuroimaging.

Patients should be followed up, and if signs of tumor progression occur, immediately be referred to the stages of specialized medical care.

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