AI Article Synopsis

  • Endovascular embolization is used as a supportive treatment for meningioma surgery, but evaluating its effectiveness is complicated because MRI scans are done before embolization and after the tumor is removed.
  • Researchers conducted a study using preoperative MRI after embolization to better measure how effective the procedure was, grading the extent of tumor devascularization and analyzing differences based on tumor location and blood supply.
  • The study found that the degree of devascularization correlated well with the volumetric extent of embolization, providing a clearer and more quantifiable way to assess the effectiveness of embolization before surgery.

Article Abstract

Background: Endovascular embolization is an adjunct to meningioma resection. Isolating the effectiveness of embolization is difficult as MR imaging is typically performed before embolization and after resection, and volumetric assessment of embolization on 2D angiographic imaging is challenging. We investigated the correlation between 2D angiographic and 3D MR measurements of meningioma devascularization following embolization.

Methods: We implemented a protocol for postembolization, preresection MRI. Angiographic devascularization was graded according to reduction of tumor blush from 1 (partial embolization) to 4 (complete embolization with no residual circulation supply). Volumetric extent of embolization was quantified as the percent of tumor contrast enhancement lost following embolization. Tumor embolization was analyzed according to tumor location and vascular supply.

Results: Thirty consecutive patients met inclusionary criteria. Grade 1 devascularization was achieved in 7% of patients, grade 2 in 43%, grade 3 in 20%, and grade 4 in 30%. Average extent of embolization was 37 ± 6%. Extent of tumor embolization was low (<25%) in 40%, moderate (25%-75%) in 40%, and high (>75%) in 20% of patients. Convexity, parasagittal/falcine and sphenoid wing tumors were found to have distinct vascular supply patterns and extent of embolization. Angiographic devascularization grade was significantly correlated with volumetric extent of tumor embolization (< 0.001, = 0.758).

Conclusion: This is the first study to implement postembolization, preoperative MRI to assess extent of embolization prior to meningioma resection. The study demonstrates that volumetric assessment of contrast reduction following embolization provides a quantitative and spatially resolved framework for assessing extent of tumor embolization.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569758PMC
http://dx.doi.org/10.1177/15910199241267312DOI Listing

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