Materiały źródłowe

• #1 EANO guideline on the diagnosis and management of meningiomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8563316/

  Meningiomas are the most common intracranial tumors. […] A provisional diagnosis of meningioma is typically made by neuroimaging, mostly magnetic resonance imaging. […] A surgical intervention with tissue, commonly with the goal of gross total resection, is required for the definitive diagnosis according to the WHO classification. […] A role for molecular profiling including gene panel sequencing and genomic methylation profiling is emerging. […] MRI and computed tomography (CT) scans, when used in combination, allow the diagnosis of intracranial meningiomas with high probability in most cases. […] Typically, meningiomas are isointense on T1-weighted sequences and hyperintense on T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. […] Meningiomas express somatostatin receptor 2 and can be delineated by PET after injection of somatostatin analogs such as 68Ga-DOTATATE or 90Y-DOTATOC.

• #2 Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions

  https://www.mdpi.com/2227-9059/9/3/319

  Meningiomas are the most common intracranial tumor, making up more than a third of all primary central nervous system (CNS) tumors. […] Advances in genomics and molecular characteristics of meningiomas have uncovered potential use for more accurate grading and prediction of prognosis and recurrence. […] This review discusses the recent 2016 updates to the World Health Organization (WHO) classification of CNS tumors, epidemiology, and etiological/risk factors of meningiomas. This review also covers molecular characteristics and potential applications for grading, clinical features, diagnostics, standard treatment regimens, and ongoing trials of potential treatments. […] The World Health Organization (WHO) grading system for tumors is the standard for grading meningiomas. […] The most current guidelines (WHO 2016) classified meningiomas into 15 subtypes across 3 grades on the basis of histologic criteria.

• #3 Meningioma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560538/

  Meningioma is a known benign central nervous system tumor commonly arising from the meninges of the brain and spinal cord. […] Prompt diagnosis, as well as understanding the severity of the tumor, would aid in the better future management of the patient. […] Brain magnetic resonance imaging (MRI) is the gold standard radiological investigation for diagnosing meningioma. […] The best radiological method to diagnose meningioma is a brain MRI with contrast. […] The diagnosis of meningioma is based on history, physical examination, and radiological investigations. […] A head contrast-enhanced CT scan can be useful for patients who are not fit for MRI, to visualize hyperostosis, or in cases of calcified meningiomas. […] MRI spectroscopy can be used to detect malignant meningiomas. […] Digital subtraction angiography (DSA) is used to demonstrate the feeding arteries of a meningioma and to distinguish between pial and dural blood supply. […] The recurrence rate of meningioma depends on the histological grade and degree of resection.

• #4 Meningioma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17858-meningioma

  A meningioma can be difficult to diagnose because it often grows slowly and often doesn’t cause symptoms until it’s big enough to affect neighboring areas of your brain. […] If your healthcare provider suspects you may have a meningioma, they’ll likely refer you to a neurologist. […] To diagnose a meningioma, your healthcare provider will perform a physical examination and a neurological examination. They’ll also recommend imaging tests, such as: […] Brain MRI (magnetic resonance imaging): The best imaging test to diagnose meningioma is a brain MRI scan with contrast. An MRI scan is a painless test that produces very clear images of the organs and structures inside of your body using a large magnet, radio waves and a computer. MRI with contrast helps improve the diagnostic quality of the images.

• #5 Meningioma | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/neurosciences/expert-care-for-meningioma-at-northwestern-memorial-hospital/meningioma/diagnosis

  If you have a small meningioma, you may not have symptoms. Your healthcare provider may only notice it during an exam for an unrelated issue, such as a head injury or sinus problem. […] Larger meningiomas can cause symptoms. Your healthcare provider may use these tests to diagnose your tumor: […] Neurological exam. After asking about your symptoms, your healthcare provider may do a neurological exam. They will check for changes in your motor and sensory function, vision, coordination and balance. They may also ask about your mental functioning, mood or behavior. […] Imaging. You may have an MRI or CT scan. These tests show pictures of your brain and nearby structures. […] Biopsy. Your healthcare provider may surgically remove a sample of the tumor. Then, they will look at it under a microscope.

• #6 Meningioma – Symptoms, Diagnosis, TreatmentSecond Opinion IconSecond Opinion IconGroup 9Group 49

  https://www.barrowneuro.org/condition/meningioma/

  Meningioma Diagnosis […] Because most meningiomas are slow-growing and typically only affect adults, symptoms can be so subtle that people often mistake them for the effects of aging. As a result, misdiagnosis is unfortunately common. […] Diagnostic imaging—like magnetic resonance imaging (MRI) or a computed tomography (CT) scan—confirms the presence of meningioma. The only way to get a definitive diagnosis is through a biopsy, when a pathologist studies a small sample taken from the tumor with a needle. […] Remember, your doctor can’t diagnose a meningioma based on symptoms alone; a definitive diagnosis requires medical imaging and a biopsy.

• #7 Meningioma Brain Tumor Treatment Signs & Symptoms | Rush

  https://www.rush.edu/conditions/meningioma

  A meningioma diagnosis can be scary, but it’s a type of brain tumor that is treatable with advanced therapies and expert care you will have access to at Rush. […] Meningiomas are the most common kind of brain tumor accounting for about 15% of all brain tumors and most are treatable. These slow-growing tumors often are benign and can be removed surgically. […] Your first step of treatment will be the diagnosis. Your doctor may recommend one of the following tests to determine if you have a meningioma and to treat your brain tumor: […] A CT scan shows detailed images of your brain. […] Magnetic resonance imaging (MRI) is a diagnostic procedure that uses a combination of large magnets, radiofrequency and a computer to produce detailed images of organs and structures within the body. […] Skull base surgery is used to treat a meningioma or sinus and other skull base tumors, as well as other abnormalities near the bottom of the skull.

• #8 Finding Answers: Jeff’s Journey to a Meningioma Diagnosis and Recovery

  https://www.ouhealth.com/blog/2024/november/finding-answers-jeff-s-journey-to-a-meningioma-d/

  Jeff went to the emergency room the next morning and told the doctor that, on top of his other symptoms, he was dragging his right foot. Brain imaging revealed that Jeff had a mass the size of a grapefruit pushing on his frontal lobes most likely a benign tumor called a meningioma. […] A meningioma is a tumor that originates from the membranes surrounding the brain and spinal cord the meninges. Meningiomas arise within the central nervous system but outside of the brain and nerves themselves, resulting in a mass that can put pressure on nearby brain structures, nerves, and blood vessels as it grows. Meningioma is the most common benign intracranial tumor and occurs in approximately 97 out of every 100,000 people annually. […] In the United States, more than 170,000 adults over 35 are diagnosed with meningioma each year. They typically grow slowly over many years and symptoms may be absent or very subtle at first. Symptoms vary considerably depending on the location of the meningioma; however, common presentations may include: Changes in vision, including double vision or blurriness, Headaches, typically worse in the morning, Hearing loss or ringing in the ears, especially on just one side, Memory loss, Loss of smell, Seizures, Weakness in the arms or legs, especially on just one side, Difficulty speaking or finding ones words.

• #9 Meningioma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/meningioma/symptoms-causes/syc-20355643

  A meningioma is a tumor that grows from the membranes that surround the brain and spinal cord, called the meninges. […] Because most meningiomas grow slowly, often without symptoms, they do not always need treatment right away. Instead, they may be watched over time. […] Often, because meningiomas do not cause any symptoms you notice, they are found only from imaging scans done for other reasons. […] Diagnosis treatment March 29, 2024. […] Seek emergency care if you have: Sudden onset of seizures. Sudden changes in vision or memory. […] Make an appointment to see your healthcare professional if you have lasting symptoms that worry you, such as headaches that get worse over time. […] Meningioma diagnosis and treatment. National Cancer Institute. […] Park JK. Epidemiology, pathology, clinical features, and diagnosis of meningioma.

• #10 Finding Answers: Jeff’s Journey to a Meningioma Diagnosis and Recovery

  https://www.ouhealth.com/blog/2024/november/finding-answers-jeff-s-journey-to-a-meningioma-d/

  Jeff went to the emergency room the next morning and told the doctor that, on top of his other symptoms, he was dragging his right foot. Brain imaging revealed that Jeff had a mass the size of a grapefruit pushing on his frontal lobes most likely a benign tumor called a meningioma. […] A meningioma is a tumor that originates from the membranes surrounding the brain and spinal cord the meninges. Meningiomas arise within the central nervous system but outside of the brain and nerves themselves, resulting in a mass that can put pressure on nearby brain structures, nerves, and blood vessels as it grows. Meningioma is the most common benign intracranial tumor and occurs in approximately 97 out of every 100,000 people annually. […] In the United States, more than 170,000 adults over 35 are diagnosed with meningioma each year. They typically grow slowly over many years and symptoms may be absent or very subtle at first. Symptoms vary considerably depending on the location of the meningioma; however, common presentations may include: Changes in vision, including double vision or blurriness, Headaches, typically worse in the morning, Hearing loss or ringing in the ears, especially on just one side, Memory loss, Loss of smell, Seizures, Weakness in the arms or legs, especially on just one side, Difficulty speaking or finding ones words.

• #11 Meningioma | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/neurosciences/expert-care-for-meningioma-at-northwestern-memorial-hospital/meningioma/diagnosis

  If you have a small meningioma, you may not have symptoms. Your healthcare provider may only notice it during an exam for an unrelated issue, such as a head injury or sinus problem. […] Larger meningiomas can cause symptoms. Your healthcare provider may use these tests to diagnose your tumor: […] Neurological exam. After asking about your symptoms, your healthcare provider may do a neurological exam. They will check for changes in your motor and sensory function, vision, coordination and balance. They may also ask about your mental functioning, mood or behavior. […] Imaging. You may have an MRI or CT scan. These tests show pictures of your brain and nearby structures. […] Biopsy. Your healthcare provider may surgically remove a sample of the tumor. Then, they will look at it under a microscope.

• #12 Diagnosing Meningioma | NYU Langone Health

  https://nyulangone.org/conditions/meningioma/diagnosis

  Diagnosing Meningioma […] To diagnose the condition, your NYU Langone doctor asks about your medical history and looks for symptoms associated with meningioma. A detailed neurological examination is then done to discover if the tumor is producing any signs of neurological changes. Tests may include a detailed vision examination and hearing test. […] Your doctor may order imaging tests to identify the tumor. […] An MRI scan uses magnets and radio waves to create detailed three-dimensional images that are sent to a computer. Our doctors use a contrast agent, which is injected into a vein before the procedure, to enhance images of the brain and skull base and the spine (for spinal meningiomas). […] Meningiomas can be identified by their location and shape, as well as how the cells appear when enhanced by the contrast agent. The diagnosis can be made with a high likelihood of accuracy, but the ultimate proof is the examination of tissue under a microscope, after the tumor has been removed with surgery.

• #13 Meningioma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560538/

  Meningioma is a known benign central nervous system tumor commonly arising from the meninges of the brain and spinal cord. […] Prompt diagnosis, as well as understanding the severity of the tumor, would aid in the better future management of the patient. […] Brain magnetic resonance imaging (MRI) is the gold standard radiological investigation for diagnosing meningioma. […] The best radiological method to diagnose meningioma is a brain MRI with contrast. […] The diagnosis of meningioma is based on history, physical examination, and radiological investigations. […] A head contrast-enhanced CT scan can be useful for patients who are not fit for MRI, to visualize hyperostosis, or in cases of calcified meningiomas. […] MRI spectroscopy can be used to detect malignant meningiomas. […] Digital subtraction angiography (DSA) is used to demonstrate the feeding arteries of a meningioma and to distinguish between pial and dural blood supply. […] The recurrence rate of meningioma depends on the histological grade and degree of resection.

• #14 Meningioma: Diagnosis, Treatment & Surgery | Pacific Brain Tumor Center

  https://www.pacificneuroscienceinstitute.org/brain-tumor/conditions/meningioma/

  Meningiomas are best diagnosed by an MRI of the brain with gadolinium, or by a CT scan of the brain with contrast. […] For midline skull base meningiomas adjacent to the pituitary gland, a focused MRI of the pituitary region, or orbits is often indicated to obtain better anatomical detail of a meningioma. […] Other tests may also be needed such as angiography (a CT angiogram or an MR angiogram), visual field tests, and pituitary hormonal tests.

• #15 Meningioma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17858-meningioma

  A meningioma can be difficult to diagnose because it often grows slowly and often doesn’t cause symptoms until it’s big enough to affect neighboring areas of your brain. […] If your healthcare provider suspects you may have a meningioma, they’ll likely refer you to a neurologist. […] To diagnose a meningioma, your healthcare provider will perform a physical examination and a neurological examination. They’ll also recommend imaging tests, such as: […] Brain MRI (magnetic resonance imaging): The best imaging test to diagnose meningioma is a brain MRI scan with contrast. An MRI scan is a painless test that produces very clear images of the organs and structures inside of your body using a large magnet, radio waves and a computer. MRI with contrast helps improve the diagnostic quality of the images.

• #16 Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions

  https://www.mdpi.com/2227-9059/9/3/319

  The initial tentative diagnosis of meningiomas can be made via magnetic resonance imaging (MRI) or contrast-enhanced computed tomography (CT) in patients with contraindications to MRI. […] Meningiomas on MRI are usually hypo- to isointense relative to the cerebral cortex on T1-weighted sequences and iso- to hyperintense on T2-weighted sequences, displaying strong homogeneous enhancement following administration of gadolinium contrast. […] Histological verification helps rule out other diagnosis such as metastasis. […] Meningiomas can present with histologic features such as pathognomonic whorls, and intranuclear cytoplasmic pseudoinclusions and psammoma bodies. […] Treatment for meningiomas is highly individualized and includes a combination of observation, surgical resection, radiotherapy, and rarely chemotherapy.

• #17 Meningioma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/meningioma?lang=us

  Meningiomas are extra-axial tumors and represent the most common tumor of the meninges. They are a non-glial neoplasm that originates from the meningocytes or arachnoid cap cells of the meninges and are located anywhere that meninges are found and in some places where only rest cells are presumed to be located. […] Although they are usually easily diagnosed and are typically indolent with a low rate of recurrence following surgery, there are 15 subtypes with variable imaging features and, in some instances, more aggressive biological behavior and higher grades. […] Typical meningiomas appear as dural-based masses isointense to grey matter on both T1 and T2 weighted imaging, enhancing vividly on both MRI and CT. Some of the subtypes can vary dramatically in their imaging appearance. […] Meningiomas are best imaged with MRI with contrast as this most accurately delineates the tumor, presence of intra- and trans-osseous extension and relationship to the underlying brain. CT, however, is useful if bony anatomy is required (e.g. at the base of skull), when patients cannot have MRI, and especially when the meningioma is entirely ossified/calcified (see burnt-out meningioma).

• #18 How to recognize and treat meningiomas | Medmastery

  https://www.medmastery.com/guides/neurology-diseases-clinical-guide/how-recognize-and-treat-meningiomas?srsltid=AfmBOoqFmqJvlLrFwcCEosupyM1lEDX5ASYlCVY9pAv0JB6ZuYvzfU_E

  On MRI, meningiomas are usually clearly discernable from normal brain tissue. However, they tend to be of the same intensity as the surrounding brain on non-contrast T1- and T2-weighted images. […] Most meningiomas will enhance (e.g., become very bright) with the administration of intravenous contrast, so a meningioma will appear much brighter on a T1-weighted post-contrast MRI in comparison to a pre-contrast MRI. […] When reviewing a meningioma on MRI, measure the tumor size at its greatest diameters. Look for associated brain compression, distortion, and associated shift of midline structures. […] Also, look for a line of enhancement immediately adjacent to the tumor along the dura. This is known as a dural tail and is a common finding with meningiomas. […] On computed tomography (CT), there is often calcification in the tumor. Also, the adjacent skull may appear thickened and more dense than normal.

• #19 Meningioma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/meningioma?lang=us

  As is the case with most other intracranial pathology, MRI is the investigation of choice for the diagnosis and characterization of meningiomas. When appearance and location are typical, the diagnosis can be made with a very high degree of certainty. In some instances, however, the appearances are atypical and careful interpretation is needed to make a correct preoperative diagnosis. […] Meningiomas typically appear as extra-axial masses with a broad dural base. They are usually homogeneous and well-circumscribed, although many variants are encountered. It seems that the signal intensity of meningiomas on T2-weighted images correlates with the histological subtypes. […] Plain films no longer have a role in the diagnosis or management of meningiomas. […] CT is often the first modality employed to investigate neurological signs or symptoms, and often is the modality which detects an incidental lesion. […] MRI findings of atypical meningioma with microcystic changes.

• #20 Meningioma: Diagnosis, Treatment & Surgery | Pacific Brain Tumor Center

  https://www.pacificneuroscienceinstitute.org/brain-tumor/conditions/meningioma/

  Meningiomas are best diagnosed by an MRI of the brain with gadolinium, or by a CT scan of the brain with contrast. […] For midline skull base meningiomas adjacent to the pituitary gland, a focused MRI of the pituitary region, or orbits is often indicated to obtain better anatomical detail of a meningioma. […] Other tests may also be needed such as angiography (a CT angiogram or an MR angiogram), visual field tests, and pituitary hormonal tests.

• #21 Diagnosing Meningioma | Expert Surgeon | Aaron Cohen-Gadol, MD

  https://www.aaroncohen-gadol.com/en/patients/meningioma/natural-history/diagnosing

  CT imaging uses a series of X-rays to generate detailed images of the brain and is often one of the first imaging modalities obtained. […] MRI uses a magnetic field and radio waves to create detailed images of soft tissue structures in the brain. […] Meningiomas are reasonably well diagnosed on MRI but in very rare cases where imaging is not diagnostic and there are some questions about the aggressiveness of the tumor, a biopsy may be performed to remove a small tissue sample from the tumor for further evaluation under a microscope by a neuropathologist. […] Meningioma grading is based on the physical appearance of tumor cells under a microscope. This helps to determine its severity and planning the best course of treatment. […] Blood tests can be used to look for inflammation, changes in protein levels, or other markers that could indicate the presence of cancer. However, many conditions can cause inflammation and alterations in normal protein levels so these cannot be used to definitively diagnose a meningioma. […] To diagnose meningiomas, doctors often use a combination of physical examination findings and imaging tests.

• #22 Diagnosing Meningioma | NYU Langone Health

  https://nyulangone.org/conditions/meningioma/diagnosis

  If after an MRI, doctors suspect a tumor is affecting the bone, they may order a CT scan, which is often better at detecting changes in bone than other imaging tests are. Meningiomas can affect the bones of the skull by causing bone destruction or, more often, excessive bone growth, also called hyperostosis. […] In a CT scan, a series of X-ray images is sent to a computer to create three-dimensional, cross-sectional pictures of the head. Before the test, you may receive a contrast agent through an injection into a vein to enhance the CT image. The CT scan exposes you to a very low level of radiation.

• #23 Review of meningioma diagnosis and management | Egyptian Journal of Neurosurgery | Full Text

  https://ejns.springeropen.com/articles/10.1186/s41984-023-00195-z

  While contrast-enhanced computed tomography (CT) may offer advantages in the identification of characteristic meningioma lesion calcification and hyperostosis, magnetic resonance imaging (MRI) offers significant advantages in tumor tissue and edema analysis. […] Another useful tool in the risk stratification of meningiomas is MRI diffusion-weighted imaging (DWI), which quantifies water diffusion levels in tissue through a reported apparent diffusion coefficient (ADC) value. […] Currently, MRI is the standard of care for the thorough assessment of meningiomas from an imaging standpoint. […] Radiomics, therefore, presents a new way to assess and diagnose meningiomas.

• #24 Meningioma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17858-meningioma

  CT (computed tomography) scan: If you can’t undergo an MRI, your healthcare provider will likely recommend a head CT scan with contrast. CT scans create detailed images of the structures inside of your body using X-rays and computers. The contrast agent, sometimes called a dye, improves the images by highlighting certain features. […] Sometimes, if the diagnosis is in doubt, a biopsy may be needed to confirm the diagnosis of meningioma and exclude other possible diagnoses. Your neurosurgeon will perform the biopsy to obtain a small tissue sample. The tissue sample will be examined to establish a diagnosis, determine whether the tumor is benign or malignant, and decide on a tumor grade.

• #25 Spinal Meningioma Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/spinal-meningioma

  Meningiomas are usually benign (noncancerous), slow-growing tumors, although in rare cases they may be malignant and invade surrounding tissue. […] Imaging studies are the key component in the diagnosis of meningiomas. Magnetic resonance (MR) scans provide useful detail about the tumors size, location, and effect on surrounding structures. […] Computed tomography (CT) can be useful in patients with pacemakers or other metallic devices, who cannot undergo MR imaging.

• #26 Meningioma Workup: Imaging Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1156552-workup

  Imaging studies are the mainstay of diagnosis. […] On plain head CT scans, meningiomas are usually dural-based tumors that are isoattenuating to slightly hyperattenuating. […] They enhance homogeneously and intensely after the injection of iodinated contrast material. […] If a meningioma is suspected, obtaining an enhanced MRI is imperative. […] Meningiomas enhance intensely and homogeneously after injection of gadolinium gadopentetate. […] Endovascular angiography allows the surgeon to preoperatively determine the vascularization of the tumor and its encroachment on vital vascular structures. […] Although magnetic resonance arteriography (MRA) and magnetic resonance venography (MRV) have decreased the role of classical angiography, the latter remains a powerful tool for planning surgery.

• #27 Meningioma: Understanding Symptoms, Diagnosis, And Treatment Options | The Lifesciences Magazine

  https://thelifesciencesmagazine.com/meningioma-symptom-diagnosis-treatment/

  Meningioma: Understanding Symptoms, Diagnosis, and Treatment Options | The Lifesciences Magazine […] The diagnosis typically involves a combination of imaging studies and histopathological evaluation. Magnetic resonance imaging (MRI) is the imaging modality of choice for visualizing, providing detailed anatomical information, and delineating tumor characteristics such as size, location, and vascularity. […] Histopathological examination of tissue samples obtained through biopsy or surgical resection confirms the diagnosis and provides valuable insights into tumor grade and subtype. […] In addition to MRI and CT scans, advanced imaging techniques such as magnetic resonance spectroscopy (MRS) and perfusion-weighted imaging (PWI) can provide valuable functional information about, such as metabolic activity and blood flow characteristics.

• #28 Review of meningioma diagnosis and management | Egyptian Journal of Neurosurgery | Full Text

  https://ejns.springeropen.com/articles/10.1186/s41984-023-00195-z

  While contrast-enhanced computed tomography (CT) may offer advantages in the identification of characteristic meningioma lesion calcification and hyperostosis, magnetic resonance imaging (MRI) offers significant advantages in tumor tissue and edema analysis. […] Another useful tool in the risk stratification of meningiomas is MRI diffusion-weighted imaging (DWI), which quantifies water diffusion levels in tissue through a reported apparent diffusion coefficient (ADC) value. […] Currently, MRI is the standard of care for the thorough assessment of meningiomas from an imaging standpoint. […] Radiomics, therefore, presents a new way to assess and diagnose meningiomas.

• #29 Meningioma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560538/

  Meningioma is a known benign central nervous system tumor commonly arising from the meninges of the brain and spinal cord. […] Prompt diagnosis, as well as understanding the severity of the tumor, would aid in the better future management of the patient. […] Brain magnetic resonance imaging (MRI) is the gold standard radiological investigation for diagnosing meningioma. […] The best radiological method to diagnose meningioma is a brain MRI with contrast. […] The diagnosis of meningioma is based on history, physical examination, and radiological investigations. […] A head contrast-enhanced CT scan can be useful for patients who are not fit for MRI, to visualize hyperostosis, or in cases of calcified meningiomas. […] MRI spectroscopy can be used to detect malignant meningiomas. […] Digital subtraction angiography (DSA) is used to demonstrate the feeding arteries of a meningioma and to distinguish between pial and dural blood supply. […] The recurrence rate of meningioma depends on the histological grade and degree of resection.

• #30 EANO guideline on the diagnosis and management of meningiomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8563316/

  Meningiomas are the most common intracranial tumors. […] A provisional diagnosis of meningioma is typically made by neuroimaging, mostly magnetic resonance imaging. […] A surgical intervention with tissue, commonly with the goal of gross total resection, is required for the definitive diagnosis according to the WHO classification. […] A role for molecular profiling including gene panel sequencing and genomic methylation profiling is emerging. […] MRI and computed tomography (CT) scans, when used in combination, allow the diagnosis of intracranial meningiomas with high probability in most cases. […] Typically, meningiomas are isointense on T1-weighted sequences and hyperintense on T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. […] Meningiomas express somatostatin receptor 2 and can be delineated by PET after injection of somatostatin analogs such as 68Ga-DOTATATE or 90Y-DOTATOC.

• #31 Meningioma Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/meningioma

  Meningiomas usually are benign, slow-growing tumors, although, in rare cases, they may be malignant and invade the surrounding brain tissue. […] Imaging studies are the key component in the diagnosis of meningiomas. Skull X-rays can be used to spot a meningioma, and computed tomography (CT) and magnetic resonance imaging (MRI) scans are used to provide increased levels of detail. […] An angiogram, which allows physicians to visualize the blood vessels in the area, may also be used.

• #32 Meningioma Workup: Imaging Studies, Procedures, Histologic Findings

  https://emedicine.medscape.com/article/1156552-workup

  Imaging studies are the mainstay of diagnosis. […] On plain head CT scans, meningiomas are usually dural-based tumors that are isoattenuating to slightly hyperattenuating. […] They enhance homogeneously and intensely after the injection of iodinated contrast material. […] If a meningioma is suspected, obtaining an enhanced MRI is imperative. […] Meningiomas enhance intensely and homogeneously after injection of gadolinium gadopentetate. […] Endovascular angiography allows the surgeon to preoperatively determine the vascularization of the tumor and its encroachment on vital vascular structures. […] Although magnetic resonance arteriography (MRA) and magnetic resonance venography (MRV) have decreased the role of classical angiography, the latter remains a powerful tool for planning surgery.

• #33 Diagnosing Meningioma | NYU Langone Health

  https://nyulangone.org/conditions/meningioma/diagnosis

  Diagnosing Meningioma […] To diagnose the condition, your NYU Langone doctor asks about your medical history and looks for symptoms associated with meningioma. A detailed neurological examination is then done to discover if the tumor is producing any signs of neurological changes. Tests may include a detailed vision examination and hearing test. […] Your doctor may order imaging tests to identify the tumor. […] An MRI scan uses magnets and radio waves to create detailed three-dimensional images that are sent to a computer. Our doctors use a contrast agent, which is injected into a vein before the procedure, to enhance images of the brain and skull base and the spine (for spinal meningiomas). […] Meningiomas can be identified by their location and shape, as well as how the cells appear when enhanced by the contrast agent. The diagnosis can be made with a high likelihood of accuracy, but the ultimate proof is the examination of tissue under a microscope, after the tumor has been removed with surgery.

• #34 Meningioma: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17858-meningioma

  CT (computed tomography) scan: If you can’t undergo an MRI, your healthcare provider will likely recommend a head CT scan with contrast. CT scans create detailed images of the structures inside of your body using X-rays and computers. The contrast agent, sometimes called a dye, improves the images by highlighting certain features. […] Sometimes, if the diagnosis is in doubt, a biopsy may be needed to confirm the diagnosis of meningioma and exclude other possible diagnoses. Your neurosurgeon will perform the biopsy to obtain a small tissue sample. The tissue sample will be examined to establish a diagnosis, determine whether the tumor is benign or malignant, and decide on a tumor grade.

• #35 Meningioma | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/neurosciences/expert-care-for-meningioma-at-northwestern-memorial-hospital/meningioma/diagnosis

  A neuropathologist (a physician who looks at brain tissue to diagnose diseases) will be part of your care team. This specialist looks at tumors under a microscope and grades them. This involves comparing abnormal tumor cells to healthy cells. The grade gives your care team an idea of how the tumor may act.

• #36 Meningioma: Diagnosis and Treatment – NCI

  https://www.cancer.gov/rare-brain-spine-tumor/tumors/meningioma

  To get an accurate diagnosis, a piece of tumor tissue will be removed during surgery, if possible. A neuropathologist should then review the tumor tissue. […] Primary CNS tumors are graded based on a tumor tissue analysis performed by a neuropathologist. Meningiomas are grouped into three grades based on their characteristics. […] Grade 2 and 3 meningiomas usually appear as an enhancing mass on the outside lining of the brain tissue, which may or may not brighten with contrast on a magnetic resonance imaging (MRI) scan. […] The cause of meningiomas is not known. However, exposure to radiation, especially in childhood, can increase a persons risk of developing a meningioma. […] Meningiomas can spread to other areas of the CNS through cerebrospinal fluid (CSF). Grade 2 meningiomas can invade surrounding tissue, including nearby bone tissue. Grade 3 meningiomas have irregular cells and are likely to invade the brain or spread to other organs in the body.

• #37 Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions

  https://www.mdpi.com/2227-9059/9/3/319

  The initial tentative diagnosis of meningiomas can be made via magnetic resonance imaging (MRI) or contrast-enhanced computed tomography (CT) in patients with contraindications to MRI. […] Meningiomas on MRI are usually hypo- to isointense relative to the cerebral cortex on T1-weighted sequences and iso- to hyperintense on T2-weighted sequences, displaying strong homogeneous enhancement following administration of gadolinium contrast. […] Histological verification helps rule out other diagnosis such as metastasis. […] Meningiomas can present with histologic features such as pathognomonic whorls, and intranuclear cytoplasmic pseudoinclusions and psammoma bodies. […] Treatment for meningiomas is highly individualized and includes a combination of observation, surgical resection, radiotherapy, and rarely chemotherapy.

• #38 Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions

  https://www.mdpi.com/2227-9059/9/3/319

  Meningiomas are the most common intracranial tumor, making up more than a third of all primary central nervous system (CNS) tumors. […] Advances in genomics and molecular characteristics of meningiomas have uncovered potential use for more accurate grading and prediction of prognosis and recurrence. […] This review discusses the recent 2016 updates to the World Health Organization (WHO) classification of CNS tumors, epidemiology, and etiological/risk factors of meningiomas. This review also covers molecular characteristics and potential applications for grading, clinical features, diagnostics, standard treatment regimens, and ongoing trials of potential treatments. […] The World Health Organization (WHO) grading system for tumors is the standard for grading meningiomas. […] The most current guidelines (WHO 2016) classified meningiomas into 15 subtypes across 3 grades on the basis of histologic criteria.

• #39 Meningioma: Diagnosis and Treatment – NCI

  https://www.cancer.gov/rare-brain-spine-tumor/tumors/meningioma

  To get an accurate diagnosis, a piece of tumor tissue will be removed during surgery, if possible. A neuropathologist should then review the tumor tissue. […] Primary CNS tumors are graded based on a tumor tissue analysis performed by a neuropathologist. Meningiomas are grouped into three grades based on their characteristics. […] Grade 2 and 3 meningiomas usually appear as an enhancing mass on the outside lining of the brain tissue, which may or may not brighten with contrast on a magnetic resonance imaging (MRI) scan. […] The cause of meningiomas is not known. However, exposure to radiation, especially in childhood, can increase a persons risk of developing a meningioma. […] Meningiomas can spread to other areas of the CNS through cerebrospinal fluid (CSF). Grade 2 meningiomas can invade surrounding tissue, including nearby bone tissue. Grade 3 meningiomas have irregular cells and are likely to invade the brain or spread to other organs in the body.

• #40 Meningioma – Wikipedia

  https://en.wikipedia.org/wiki/Meningioma

  Meningiomas are visualized readily with contrast CT, MRI with gadolinium, and arteriography, all attributed to the fact that meningiomas are extra-axial and vascularized. […] Diagnosis is typically by medical imaging. […] Although the majority of meningiomas are benign, they may have malignant presentations. Classification of meningiomas are based upon the WHO classification system. […] In a 2008 review of the latter two categories, atypical and anaplastic-meningioma cases, the mean overall survival for atypical meningiomas was found to be 11.9 years vs. 3.3 years for anaplastic meningiomas. […] The probability of a tumor recurring or growing after surgery may be estimated by comparing the tumor’s WHO (World Health Organization) grade and by the extent of surgery by the Simpson Criteria.

• #41 Meningioma: Diagnosis and Treatment – NCI

  https://www.cancer.gov/rare-brain-spine-tumor/tumors/meningioma

  To get an accurate diagnosis, a piece of tumor tissue will be removed during surgery, if possible. A neuropathologist should then review the tumor tissue. […] Primary CNS tumors are graded based on a tumor tissue analysis performed by a neuropathologist. Meningiomas are grouped into three grades based on their characteristics. […] Grade 2 and 3 meningiomas usually appear as an enhancing mass on the outside lining of the brain tissue, which may or may not brighten with contrast on a magnetic resonance imaging (MRI) scan. […] The cause of meningiomas is not known. However, exposure to radiation, especially in childhood, can increase a persons risk of developing a meningioma. […] Meningiomas can spread to other areas of the CNS through cerebrospinal fluid (CSF). Grade 2 meningiomas can invade surrounding tissue, including nearby bone tissue. Grade 3 meningiomas have irregular cells and are likely to invade the brain or spread to other organs in the body.

• #42 Meningioma – Wikipedia

  https://en.wikipedia.org/wiki/Meningioma

  Meningiomas are visualized readily with contrast CT, MRI with gadolinium, and arteriography, all attributed to the fact that meningiomas are extra-axial and vascularized. […] Diagnosis is typically by medical imaging. […] Although the majority of meningiomas are benign, they may have malignant presentations. Classification of meningiomas are based upon the WHO classification system. […] In a 2008 review of the latter two categories, atypical and anaplastic-meningioma cases, the mean overall survival for atypical meningiomas was found to be 11.9 years vs. 3.3 years for anaplastic meningiomas. […] The probability of a tumor recurring or growing after surgery may be estimated by comparing the tumor’s WHO (World Health Organization) grade and by the extent of surgery by the Simpson Criteria.

• #43 Understanding Your Meningioma Diagnosis | What To Expect

  https://www.valleygammaknife.com/meningioma-diagnosis/

  What to Expect From a Meningioma Diagnosis […] After Your Meningioma Diagnosis […] Take some time to learn about your meningioma so you can better understand your condition and treatment options. […] A meningioma is a tumor that develops from the meninges. Meningiomas are classified by grade, ranging from grade I to III. This classification is based on the aggressiveness of the tumor and requires a biopsy, or sample of the tissue, which is then examined by a pathologist. […] The majority of meningiomas are benign. This means they do not spread to other sites of the body and do not invade local tissues. However, some patients will have more aggressive meningiomas, which likewise require more aggressive treatment. This potential for malignancy is what makes the next step so important.

• #44 Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions

  https://www.mdpi.com/2227-9059/9/3/319

  The potential consequences of different treatments can vary greatly. […] The „wait-and-see” observation approach is a common strategy used for patients with incidentally diagnosed meningiomas that are small (tumor diameter ≤3 cm) and asymptomatic. […] Surgical resection is the primary choice for symptomatic, observation failure meningiomas, or large tumors that are anticipated to cause symptoms soon. […] Radiotherapy has become a first-line treatment for unresectable meningiomas, such as certain skull base meningiomas that have encased neurovascular structures. […] The 10-year overall survival rate of WHO grades I, II, and III tumors are 83.7%, 53%, and 0%, respectively, despite aggressive therapy efforts. […] The 5-year recurrence rates of WHO grades I, II, and III tumors after Simpson grade I GTR are 7–23%, 50–55%, and 72–78%, respectively. […] While systemic therapy is still under investigation, it is reserved for meningiomas that are recurrent or progressive that no longer respond to surgery and radiotherapy.

• #45 Meningioma – Wikipedia

  https://en.wikipedia.org/wiki/Meningioma

  Meningiomas are visualized readily with contrast CT, MRI with gadolinium, and arteriography, all attributed to the fact that meningiomas are extra-axial and vascularized. […] Diagnosis is typically by medical imaging. […] Although the majority of meningiomas are benign, they may have malignant presentations. Classification of meningiomas are based upon the WHO classification system. […] In a 2008 review of the latter two categories, atypical and anaplastic-meningioma cases, the mean overall survival for atypical meningiomas was found to be 11.9 years vs. 3.3 years for anaplastic meningiomas. […] The probability of a tumor recurring or growing after surgery may be estimated by comparing the tumor’s WHO (World Health Organization) grade and by the extent of surgery by the Simpson Criteria.

• #46 Review of meningioma diagnosis and management | Egyptian Journal of Neurosurgery | Full Text

  https://ejns.springeropen.com/articles/10.1186/s41984-023-00195-z

  Meningiomas are the most common intracranial tumors in adult patients. […] This review will cover diagnostic strategies for meningiomas, including 2021 updates to the World Health Organizations grading of meningiomas. […] Meningiomas are primarily first seen and diagnosed as a result of imaging. […] The World Health Organization (WHO) grading is considered to be the gold standard in classifying histological and etiological meningioma factors. […] The 2021 revision of the WHO guidelines further emphasizes the review of genomic alterations to support tumor classification and assist clinicians with meningioma management. […] The clinicopathological relevance of genetic alterations in meningiomas is still being studied, but certain alterations are seen more frequently in varying subtypes and locations of meningioma.

• #47 Unveiling a Biomarker Signature of Meningioma: The Need for a Panel of Genomic, Epigenetic, Proteomic, and RNA Biomarkers to Advance Diagnosis and Prognosis

  https://www.mdpi.com/2072-6694/15/22/5339

  MRI and histological assessment remain the gold standard for meningioma diagnosis. Currently, WHO grading of meningiomas mainly depends on histologic and morphological markers and two molecular markers. WHO grading can reliably diagnose meningiomas in most cases. However, it was not as dependable in predicting prognosis, especially time to recurrence of Grade 1 and 2 meningiomas. This warrants the integration of new biomarkers into the current WHO grading system of meningiomas. Future meningioma biomarkers need to utilize an array of molecular technologies for biomarkers discovery, including genomic, epigenetic, proteomic, metabolomic, and RNA biomarkers, as well as a panel format to complement the existing WHO grading. The majority of candidate meningioma molecular biomarkers are still experimental and need to undergo testing in clinical trials, but their application in meningioma diagnosis will be necessary to guide future targeted therapies of meningiomas.

• #48 Review of meningioma diagnosis and management | Egyptian Journal of Neurosurgery | Full Text

  https://ejns.springeropen.com/articles/10.1186/s41984-023-00195-z

  Meningiomas are the most common intracranial tumors in adult patients. […] This review will cover diagnostic strategies for meningiomas, including 2021 updates to the World Health Organizations grading of meningiomas. […] Meningiomas are primarily first seen and diagnosed as a result of imaging. […] The World Health Organization (WHO) grading is considered to be the gold standard in classifying histological and etiological meningioma factors. […] The 2021 revision of the WHO guidelines further emphasizes the review of genomic alterations to support tumor classification and assist clinicians with meningioma management. […] The clinicopathological relevance of genetic alterations in meningiomas is still being studied, but certain alterations are seen more frequently in varying subtypes and locations of meningioma.

• #49 Meningioma – American Brain Tumor Association | Learn More

  https://www.abta.org/tumor_types/meningioma/

  Drug therapy may be used to treat meningiomas that cannot be removed surgically, when radiation therapy is contraindicated, or if the meningioma recurs or comes back. […] Molecular profiling is the detection of specific genes, proteins, or other molecules in a tumor. This information helps confirm tumor diagnosis, inform treatment options, and predict prognosis.

• #50 Pathology Outlines – Meningioma

  https://www.pathologyoutlines.com/topic/cnstumormeningiomageneral.html

  Most common primary CNS tumor, arising from arachnoid cap cells associated with dura mater or choroid plexus, accounting for 36% all CNS tumors (Neuro Oncol 2015;17:iv1) […] Diagnose by imaging and pathology of biopsy / resection specimen […] Extra-axial mass with dural tail […] Uniformly contrast enhancing […] Extensive peritumoral edema is usually associated with brain invasion (Neuro Oncol 2021;23:324) […] Most recently, DNA methylation profiling is reported to better predict tumor recurrence and prognosis than the WHO histological classification (Lancet Oncol 2017;18:682) […] Recurrent losses of chromosome 1p, 6q, 14q, 18q and gain of 1q are indicators of poor prognosis (Acta Neuropathol 2017;133:431) […] Loss of H3K27 trimethylation (H3K27me3) by IHC predicts poor prognosis in grade 1 and 2 meningiomas but not grade 3 (Acta Neuropathol 2018;135:955) […] TERT promoter mutation is seen in high grade meningioma progressed from low grade, not in primary atypical meningioma (Brain Pathol 2014;24:184) […] The low grade meningioma variants that may have prominent peritumoral edema are secretory, angiomatous, microcystic and lymphoplasmacyte rich.

• #51 Pathology Outlines – Meningioma

  https://www.pathologyoutlines.com/topic/cnstumormeningiomageneral.html

  Most common primary CNS tumor, arising from arachnoid cap cells associated with dura mater or choroid plexus, accounting for 36% all CNS tumors (Neuro Oncol 2015;17:iv1) […] Diagnose by imaging and pathology of biopsy / resection specimen […] Extra-axial mass with dural tail […] Uniformly contrast enhancing […] Extensive peritumoral edema is usually associated with brain invasion (Neuro Oncol 2021;23:324) […] Most recently, DNA methylation profiling is reported to better predict tumor recurrence and prognosis than the WHO histological classification (Lancet Oncol 2017;18:682) […] Recurrent losses of chromosome 1p, 6q, 14q, 18q and gain of 1q are indicators of poor prognosis (Acta Neuropathol 2017;133:431) […] Loss of H3K27 trimethylation (H3K27me3) by IHC predicts poor prognosis in grade 1 and 2 meningiomas but not grade 3 (Acta Neuropathol 2018;135:955) […] TERT promoter mutation is seen in high grade meningioma progressed from low grade, not in primary atypical meningioma (Brain Pathol 2014;24:184) […] The low grade meningioma variants that may have prominent peritumoral edema are secretory, angiomatous, microcystic and lymphoplasmacyte rich.

• #52 EANO guideline on the diagnosis and management of meningiomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8563316/

  Meningiomas are the most common intracranial tumors. […] A provisional diagnosis of meningioma is typically made by neuroimaging, mostly magnetic resonance imaging. […] A surgical intervention with tissue, commonly with the goal of gross total resection, is required for the definitive diagnosis according to the WHO classification. […] A role for molecular profiling including gene panel sequencing and genomic methylation profiling is emerging. […] MRI and computed tomography (CT) scans, when used in combination, allow the diagnosis of intracranial meningiomas with high probability in most cases. […] Typically, meningiomas are isointense on T1-weighted sequences and hyperintense on T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. […] Meningiomas express somatostatin receptor 2 and can be delineated by PET after injection of somatostatin analogs such as 68Ga-DOTATATE or 90Y-DOTATOC.

• #53 Unveiling a Biomarker Signature of Meningioma: The Need for a Panel of Genomic, Epigenetic, Proteomic, and RNA Biomarkers to Advance Diagnosis and Prognosis

  https://www.mdpi.com/2072-6694/15/22/5339

  MRI and histological assessment remain the gold standard for meningioma diagnosis. Currently, WHO grading of meningiomas mainly depends on histologic and morphological markers and two molecular markers. WHO grading can reliably diagnose meningiomas in most cases. However, it was not as dependable in predicting prognosis, especially time to recurrence of Grade 1 and 2 meningiomas. This warrants the integration of new biomarkers into the current WHO grading system of meningiomas. Future meningioma biomarkers need to utilize an array of molecular technologies for biomarkers discovery, including genomic, epigenetic, proteomic, metabolomic, and RNA biomarkers, as well as a panel format to complement the existing WHO grading. The majority of candidate meningioma molecular biomarkers are still experimental and need to undergo testing in clinical trials, but their application in meningioma diagnosis will be necessary to guide future targeted therapies of meningiomas.

• #54 Unveiling a Biomarker Signature of Meningioma: The Need for a Panel of Genomic, Epigenetic, Proteomic, and RNA Biomarkers to Advance Diagnosis and Prognosis

  https://www.mdpi.com/2072-6694/15/22/5339

  MRI and histological assessment remain the gold standard for meningioma diagnosis. Currently, WHO grading of meningiomas mainly depends on histologic and morphological markers and two molecular markers. WHO grading can reliably diagnose meningiomas in most cases. However, it was not as dependable in predicting prognosis, especially time to recurrence of Grade 1 and 2 meningiomas. This warrants the integration of new biomarkers into the current WHO grading system of meningiomas. Future meningioma biomarkers need to utilize an array of molecular technologies for biomarkers discovery, including genomic, epigenetic, proteomic, metabolomic, and RNA biomarkers, as well as a panel format to complement the existing WHO grading. The majority of candidate meningioma molecular biomarkers are still experimental and need to undergo testing in clinical trials, but their application in meningioma diagnosis will be necessary to guide future targeted therapies of meningiomas.

• #55 Meningioma – Diagnosis & Disease Information

  https://www.cancertherapyadvisor.com/ddi/meningioma/

  Meningioma is a type of central nervous system tumor that affects the meninges the protective layer of tissue surrounding the brain and spinal cord. […] This article covers what clinicians need to know about the risk factors, prognosis, diagnosis, and treatment of meningioma. […] Meningioma grading (Grade 1, 2, or 3) is essential for prognosis and treatment decisions. […] Imaging is Key: Utilize MRI and CT scans for diagnosis and monitoring. […] Magnetic resonance imaging and CT scans are the most common methods for diagnosing and monitoring meningiomas. […] Histology is necessary to rule out potential brain metastases from another primary cancer. […] Other CNS tumors and malignancies can produce symptoms similar to those of meningioma. […] Meningioma lesions can also be difficult to differentiate on imaging studies.

• #56 Meningioma – Diagnosis & Disease Information

  https://www.cancertherapyadvisor.com/ddi/meningioma/

  Meningioma is a type of central nervous system tumor that affects the meninges the protective layer of tissue surrounding the brain and spinal cord. […] This article covers what clinicians need to know about the risk factors, prognosis, diagnosis, and treatment of meningioma. […] Meningioma grading (Grade 1, 2, or 3) is essential for prognosis and treatment decisions. […] Imaging is Key: Utilize MRI and CT scans for diagnosis and monitoring. […] Magnetic resonance imaging and CT scans are the most common methods for diagnosing and monitoring meningiomas. […] Histology is necessary to rule out potential brain metastases from another primary cancer. […] Other CNS tumors and malignancies can produce symptoms similar to those of meningioma. […] Meningioma lesions can also be difficult to differentiate on imaging studies.

• #57

  https://link.springer.com/article/10.1007/s00428-020-02988-1

  Limited studies on whole slide imaging (WSI) in surgical neuropathology reported a perceived limitation in the recognition of mitoses. This study analyzed and compared the inter- and intra-observer concordance for atypical meningioma, using glass slides and WSI. […] The concordance rates for atypical meningioma on glass slides and on WSI were 54% and 60% among four observers and 63% and 74% between two neuropathologists. […] The higher concordance for atypical meningioma using WSI than with glass slides and the similar predictive accuracy for recurrence in the two modalities suggest that atypical meningioma may be safely diagnosed using WSI. […] Meningiomas are the most frequent primary tumors of the central nervous system and are currently classified into fifteen histotypes and three grades of malignancy.

• #58

  https://link.springer.com/article/10.1007/s00428-020-02988-1

  A previous study reported an agreement of 87% between two neuropathologists assessing the histological grade of 172 meningiomas on glass slides; the lowest concordance was encountered for grade II meningiomas due to disagreement in mitotic counts. […] For this reason, the aim of this study was to analyze and compare the inter- and intra-observer concordance in the diagnosis of atypical meningioma using glass slides and WSI. […] Our findings can be summarized as follows: (1) the inter-observer concordance for atypical meningioma was 54% on glass slides and 60% on WSI and, in both viewing modes it was related to the pathologists years of practice; (2) sub-optimal concordance rates were mainly related to low inter-observer agreement for minor atypical criteria; (3) the inter-observer agreement was higher when using WSI than with glass slides for all histopathological parameters, with the exception of high mitotic index; (4) this latter feature had the lowest intra-observer concordance between the two viewing modes, as all observers classified more cases as having a high mitotic index on WSI than on glass slides; and (5) the predictive accuracy of all histopathological parameters for recurrence was not significantly different between the two viewing modes. […] The good intra-observer agreement and similar predictive values of histopathological features in the two viewing modes demonstrate that meningiomas can be safely and accurately diagnosed using WSI. […] In conclusion, this study shows that atypical meningioma may be safely diagnosed using WSI.

• #59

  https://link.springer.com/article/10.1007/s00428-020-02988-1

  A previous study reported an agreement of 87% between two neuropathologists assessing the histological grade of 172 meningiomas on glass slides; the lowest concordance was encountered for grade II meningiomas due to disagreement in mitotic counts. […] For this reason, the aim of this study was to analyze and compare the inter- and intra-observer concordance in the diagnosis of atypical meningioma using glass slides and WSI. […] Our findings can be summarized as follows: (1) the inter-observer concordance for atypical meningioma was 54% on glass slides and 60% on WSI and, in both viewing modes it was related to the pathologists years of practice; (2) sub-optimal concordance rates were mainly related to low inter-observer agreement for minor atypical criteria; (3) the inter-observer agreement was higher when using WSI than with glass slides for all histopathological parameters, with the exception of high mitotic index; (4) this latter feature had the lowest intra-observer concordance between the two viewing modes, as all observers classified more cases as having a high mitotic index on WSI than on glass slides; and (5) the predictive accuracy of all histopathological parameters for recurrence was not significantly different between the two viewing modes. […] The good intra-observer agreement and similar predictive values of histopathological features in the two viewing modes demonstrate that meningiomas can be safely and accurately diagnosed using WSI. […] In conclusion, this study shows that atypical meningioma may be safely diagnosed using WSI.

• #60 Get Meningioma Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/meningioma-treatment

  Imaging tests can create detailed images of your brain so we can see the size and location of tumors. Some tests also map the parts of your brain that do important functions, so we can avoid these areas when treating the tumor. These tests may include: Brain MRI. CT scan. […] A neurosurgeon may do a biopsy to learn more about a brain tumor. Theyll remove a small tissue sample from the tumor. A neuropathologist (brain tissue specialist) in our lab will look at your sample under a microscope to figure out what kind of tumor you have, if its benign or malignant (cancerous) and how likely itll grow and spread (grade). […] If you choose Cleveland Clinic for meningioma diagnosis and treatment, youll have a team of experts across different specialties on your side. Theyll take a look at your tumor using leading-edge diagnostic technology and develop a highly personalized treatment plan based on your test results.

• #61 Understanding Your Meningioma Diagnosis | What To Expect

  https://www.valleygammaknife.com/meningioma-diagnosis/

  It will be important that you work with someone in the tri-state area who has experience treating meningiomas. Meningiomas can vary in size, location and aggressiveness, and the treatment that is right for you may be different from the next patient. […] Your doctor will take all of these factors into consideration, along with your personal health factors. […] Your treatment will depend on the characteristics of your meningioma (such as size, location, and grade) as well as your individual health, like age, medications and other any other conditions you have. […] Some of the potential treatment options include: Monitoring – If your meningioma is small, asymptomatic and benign, your doctor may recommend a “watch and wait” approach before any treatment. […] Surgical Removal – Some patients will need to have all or part of their meningioma removed using surgery.

• #62

• #63 Meningioma | UVA Health

  https://uvahealth.com/services/benign-brain-tumor/meningioma

  At UVA Health, we have experts in every type of treatment. […] To diagnosis a meningioma, we usually need to take images of your head and brain activity. These scans include: MRI scan, Angiogram, Electroencephalogram (EEG). […] Radiation therapy is used either on its own or after surgery has been performed. Radiation therapy is an effective way of treating the tumor and stopping its growth, especially if the tumor is not located in an area of the brain where surgery can be safely done. […] Chemotherapy is used only to treat malignant meningiomas. Different medications are available and are generally used along with surgery and radiation therapy.

• #64 All about meningioma: What patients should know | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/5-meningioma-questions–answered.h00-159466368.html

  Meningiomas are a primary central nervous system tumor that make up 38% of all primary intracranial tumors. […] The vast majority of meningiomas are benign. About 20% show more aggressive growth, and 3% or less are cancerous. When making an official diagnosis, a physician will determine the tumor grade. […] An MRI with contrast dye is best for detecting meningiomas. In some circumstances, meningiomas cannot be seen without contrast. The gadolinium-based dye identifies meningiomas with ease and provides an accurate image and diagnosis. […] Treatment will be needed if the tumor begins to grow or cause symptoms. For most healthy adults, surgery is the next step. […] If a tumor comes back or if the tumor cannot be fully removed with surgery, patients may undergo radiation therapy to destroy tumor cells and stop them from growing. Chemotherapy is also used to treat meningiomas that come back after surgery and radiation.

• #65 Meningioma: Diagnosis and Treatment – NCI

  https://www.cancer.gov/rare-brain-spine-tumor/tumors/meningioma

  The likely outcome of the disease or chance of recovery is called prognosis. Prognosis is based on tumor grade, location, tumor type, extent of tumor spread, genetic findings, the patients age, and tumor remaining after surgery (if surgery is possible). […] The first treatment for a malignant meningioma is surgery, if possible. The goal of surgery is to obtain tissue to determine the tumor type and remove as much tumor as possible without causing more symptoms.

• #66 EANO guideline on the diagnosis and management of meningiomas

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8563316/

  When management by observation is indicated, MRI is the gold standard for follow-up imaging. […] The use of conventional angiography in the diagnosis of meningioma has been steadily declining, but it may provide useful information in particular cases when a major sinus seems invaded by the tumor and MRI angiography provides insufficient information. […] Tissue asservation for molecular diagnostics and future targeted therapies is highly recommended.

• #67 Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions

  https://www.mdpi.com/2227-9059/9/3/319

  The potential consequences of different treatments can vary greatly. […] The „wait-and-see” observation approach is a common strategy used for patients with incidentally diagnosed meningiomas that are small (tumor diameter ≤3 cm) and asymptomatic. […] Surgical resection is the primary choice for symptomatic, observation failure meningiomas, or large tumors that are anticipated to cause symptoms soon. […] Radiotherapy has become a first-line treatment for unresectable meningiomas, such as certain skull base meningiomas that have encased neurovascular structures. […] The 10-year overall survival rate of WHO grades I, II, and III tumors are 83.7%, 53%, and 0%, respectively, despite aggressive therapy efforts. […] The 5-year recurrence rates of WHO grades I, II, and III tumors after Simpson grade I GTR are 7–23%, 50–55%, and 72–78%, respectively. […] While systemic therapy is still under investigation, it is reserved for meningiomas that are recurrent or progressive that no longer respond to surgery and radiotherapy.

• #68 How to recognize and treat meningiomas | Medmastery

  https://www.medmastery.com/guides/neurology-diseases-clinical-guide/how-recognize-and-treat-meningiomas?srsltid=AfmBOoqFmqJvlLrFwcCEosupyM1lEDX5ASYlCVY9pAv0JB6ZuYvzfU_E

  If the tumor is to be monitored, repeat an MRI in four months to rule out rapid growth and then repeat yearly for several years. If the tumor shows no growth, no treatment is indicated. […] Tumors that are large or are causing neurological deficits should be surgically resected. Resection can be curative, although this depends on the aggressiveness of the resection, such as the removal of the surrounding meninges. […] Obtain a follow-up MRI every year after tumor resection to screen for recurrence.

• #69 Case Report: Radiological diagnosis of atypical… | F1000Research

  https://f1000research.com/articles/13-509

  Intraoperative MRI helps to obtain tissue samples and remove the tumor during surgery. […] The biochemical profile and nature of the tumor can be better visualized using on MR spectroscopy. […] If the entire tumor is operable, the outcome is better. […] In the case of a GRADE II atypical meningioma, an MRI scan should be performed every 6-12 months. […] The main radiological investigations performed for diagnostic purposes are magnetic resonance imaging (MRI) and computed tomography. […] An atypical meningioma was diagnosed in this case, which appeared as a well-defined lesion arising from the left tentorial leaflet with surrounding perilesional vasogenic edema appearing heterogeneously isointense to hypointense on T1 Weighted Image and heterogeneously isointense to hyperintense on T2 Weighted Image and showing heterogeneous enhancement with few areas of necrosis within the contrast images. […] MR spectroscopy showed increased choline values and reduced N-acetylaspartate values, thereby showing an increased choline/NAA ratio suggesting a malignant lesion in the case of atypical meningioma.

• #70 Meningioma: A Review of Epidemiology, Pathology, Diagnosis, Treatment, and Future Directions

  https://www.mdpi.com/2227-9059/9/3/319

  The potential consequences of different treatments can vary greatly. […] The „wait-and-see” observation approach is a common strategy used for patients with incidentally diagnosed meningiomas that are small (tumor diameter ≤3 cm) and asymptomatic. […] Surgical resection is the primary choice for symptomatic, observation failure meningiomas, or large tumors that are anticipated to cause symptoms soon. […] Radiotherapy has become a first-line treatment for unresectable meningiomas, such as certain skull base meningiomas that have encased neurovascular structures. […] The 10-year overall survival rate of WHO grades I, II, and III tumors are 83.7%, 53%, and 0%, respectively, despite aggressive therapy efforts. […] The 5-year recurrence rates of WHO grades I, II, and III tumors after Simpson grade I GTR are 7–23%, 50–55%, and 72–78%, respectively. […] While systemic therapy is still under investigation, it is reserved for meningiomas that are recurrent or progressive that no longer respond to surgery and radiotherapy.

• #71 Meningioma Diagnosis Shown to Impact Patient’s Quality of Life < Yale School of Medicine

  https://medicine.yale.edu/news-article/meningioma-diagnosis-shown-to-impact-patients-quality-of-life/

  Meningiomas tumors that arise from the lining of the brain and spinal cord have recently been in the news with celebrities Kate Walsh and Maria Menounos sharing their initial shock upon diagnosis and their experiences with side effects such as memory loss, confusion and physical weakness months after surgery. […] Although most meningiomas are non-malignant, a new Yale School of Public Health-led study published in Cancer reveals that many patients experience significantly reduced quality of life (QOL) in the year after surgery, highlighting the need to continue to support such patients as they recover. […] In the study, Quality of Life After Surgery for Intracranial Meningioma, approximately 1700 patients diagnosed with meningioma were compared with a similar number of persons (matched by age, sex, race and residence) without meningioma.

• #72 Meningioma diagnosis shown to impact patient’s quality of life

  https://medicalxpress.com/news/2017-09-meningioma-diagnosis-shown-impact-patient.html

  Meningioma diagnosis shown to impact patient’s quality of life. […] Although most meningiomas are non-malignant, a new Yale School of Public Health-led study published in Cancer reveals that many patients experience significantly reduced quality of life (QOL) in the year after surgery, highlighting the need to continue to support such patients as they recover. […] In the study, „Quality of Life After Surgery for Intracranial Meningioma,” approximately 1700 patients diagnosed with meningioma were compared with a similar number of persons (matched by age, sex, race and residence) without meningioma. […] Dr. Claus said the study confirms what she has observed in her clinical practice. […] „Although the good news is the majority of meningioma patients do very well after surgery, changes in neurologic function seen prior to surgery can persist for a time even after removal of the meningioma,” she said. „It is important to make patients aware that recuperation may take months or even years. Patients may appear physically well yet be experiencing difficulty with concentration, memory, or multi-tasking, all of which may affect one’s ability to work, drive or take care of oneself or family.”

• #73 Meningioma Diagnosis Shown to Impact Patient’s Quality of Life < Yale School of Medicine

  https://medicine.yale.edu/news-article/meningioma-diagnosis-shown-to-impact-patients-quality-of-life/

  It is important to make patients aware that recuperation may take months or even years. Patients may appear physically well yet be experiencing difficulty with concentration, memory, or multi-tasking, all of which may affect ones ability to work, drive or take care of oneself or family. […] Although the good news is the majority of meningioma patients do very well after surgery, changes in neurologic function seen prior to surgery can persist for a time even after removal of the meningioma, she said.

• #74 Meningioma Diagnosis Shown to Impact Patient’s Quality of Life < Yale School of Medicine

  https://medicine.yale.edu/news-article/meningioma-diagnosis-shown-to-impact-patients-quality-of-life/

  It is important to make patients aware that recuperation may take months or even years. Patients may appear physically well yet be experiencing difficulty with concentration, memory, or multi-tasking, all of which may affect ones ability to work, drive or take care of oneself or family. […] Although the good news is the majority of meningioma patients do very well after surgery, changes in neurologic function seen prior to surgery can persist for a time even after removal of the meningioma, she said.

• #75 Finding Answers: Jeff’s Journey to a Meningioma Diagnosis and Recovery

  https://www.ouhealth.com/blog/2024/november/finding-answers-jeff-s-journey-to-a-meningioma-d/

  Jeff went home two days after the surgery and despite having some minor setbacks in his early recovery, he is now thriving, and back to his bright and energetic self. […] We have world class expertise with multiple surgeons who have trained at leading institutions ranging from Mayo Clinic to Harvard, Cleveland Clinic, UCSF, and the Barrow Neurological Institute, among others said Dr. Graffeo. We have very deep expertise treating these types of tumors, and our team is built of closely collaborating subspecialists who have tremendous experience with the full range of modern tools and techniques.

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