{"title":"Peritumoral edema resolves infrequently in surgically treated patients with intracranial meningioma- a retrospective study of 279 meningioma patients.","authors":"Joonas Laajava, Mika Niemelä, Miikka Korja","doi":"10.1007/s11060-025-04964-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The resolution of peritumoral brain edema (PTBE) following surgery for intracranial meningioma (IM) is poorly understood. We hypothesized that PTBE represents a more permanent rather than resolving parenchymal change. Therefore, our aim was to assess the frequency of PTBE resolution following gross total resection (GTR) of IM.</p><p><strong>Methods: </strong>IM patients who were operated on in the study hospital between 2000 and 2020, who had preoperative magnetic resonance imaging (MRI) showing PTBE and a follow-up MRI performed at least one year after surgery, were retrospectively identified. To minimize confounding by PTBE related to a postoperative residual tumor, only patients who had undergone GTR were included. PTBE was defined as hyperintensity on either pre- or postoperative fluid-attenuated inversion recovery (FLAIR) MRI sequences.</p><p><strong>Results: </strong>A total of 279 adult meningioma patients were retrospectively identified. Of these, 208 (74.6%) were graded as World Health Organization grade 1 and 71 (25.4%) as grade 2. Of the 279 patients who had the first postoperative follow-up MRI at one year or later, PTBE changes persisted in 270 (96.8%) patients. However, over 90% resolution in PTBE volume was observed in 102 (35.8%) patients during the median MRI follow-up of 5.0 years (2.3-6.5). Higher edema index (p <.001) and temporal PTBE location (p =.018) were associated with higher resolution percentage of preoperative PTBE.</p><p><strong>Conclusion: </strong>Persisting PTBE is a common finding following GTR of IMs. While complete resolution of PTBE is rare, considerable resolution is often seen. The nature and exact cause of these persisting parenchymal changes are unclear, but they likely represent gliosis.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuro-Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11060-025-04964-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The resolution of peritumoral brain edema (PTBE) following surgery for intracranial meningioma (IM) is poorly understood. We hypothesized that PTBE represents a more permanent rather than resolving parenchymal change. Therefore, our aim was to assess the frequency of PTBE resolution following gross total resection (GTR) of IM.
Methods: IM patients who were operated on in the study hospital between 2000 and 2020, who had preoperative magnetic resonance imaging (MRI) showing PTBE and a follow-up MRI performed at least one year after surgery, were retrospectively identified. To minimize confounding by PTBE related to a postoperative residual tumor, only patients who had undergone GTR were included. PTBE was defined as hyperintensity on either pre- or postoperative fluid-attenuated inversion recovery (FLAIR) MRI sequences.
Results: A total of 279 adult meningioma patients were retrospectively identified. Of these, 208 (74.6%) were graded as World Health Organization grade 1 and 71 (25.4%) as grade 2. Of the 279 patients who had the first postoperative follow-up MRI at one year or later, PTBE changes persisted in 270 (96.8%) patients. However, over 90% resolution in PTBE volume was observed in 102 (35.8%) patients during the median MRI follow-up of 5.0 years (2.3-6.5). Higher edema index (p <.001) and temporal PTBE location (p =.018) were associated with higher resolution percentage of preoperative PTBE.
Conclusion: Persisting PTBE is a common finding following GTR of IMs. While complete resolution of PTBE is rare, considerable resolution is often seen. The nature and exact cause of these persisting parenchymal changes are unclear, but they likely represent gliosis.
期刊介绍：
The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.
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