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Disparity of volumetric and linear measurements of meningioma response to gammaknife radiosurgery

Published online by Cambridge University Press:  03 June 2015

A Mansouri
Affiliation:
(Toronto)
S Larjani
Affiliation:
(Toronto)
G Klironomos
Affiliation:
(Toronto)
MD Cusimano
Affiliation:
(Toronto)
M Schwartz
Affiliation:
(Toronto)
G Zadeh
Affiliation:
(Toronto)
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Abstract

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Objective: To identify clinical, radiological, and dosimetric predictors of meningioma response to stereotactic radiosurgery (SRS), and post-SRS adverse radiation events (ARE). Methodology: A retrospective review was conducted. Seventy-five patients had at least 24 months of clinical and radiological follow-up. Tumor control was defined as any volumetric/diametric change less than +10%. Volumetric measurements were made using T1-Gadolinium enhanced 3T MRI scans with ITK-SNAP2.2 software. Univariate statistics were used to identify predictors of post SRS AREs. Results: Females comprised 69.3% of patients, mean treatment age was 58.6 years, and median follow up was 36.2 months. Twenty-one patients had undergone prior surgical resection. Volumetric tumor control (52%) was inferior to diametric control (92%). Twenty-six patients (34.6%) experienced some form of new-onset complication after SRS: Headache (17.3%), cranial neuropathy (10.6%), speech impairment (2.7%), tremor (2.7%), and ataxia (1.3%). Fourteen patients (18.7%) experienced new onset T2 signal change signifying of edema; eight of these patients were symptomatic. Lower Conformity index (1.24 vs. 1.4), and higher treatment-volume ratio (TVR) (0.80 vs. 0.72) were significantly associated with development of edema after SRS (p<0.05, power > 0.8). Conclusion: Volume-based reporting of SRS outcomes for meningiomas is more accurate for reporting tumor control. Conformity index and TVR were identified as predictors of edema following radiosurgery.

Type
CNSS Platform Presentations
Copyright
Copyright © The Canadian Journal of Neurological Sciences Inc. 2015