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dc.contributor.authorVarlotto, John
dc.contributor.authorFlickinger, John
dc.contributor.authorPavelic, Martin T.
dc.contributor.authorSpecht, Charles S.
dc.contributor.authorSheehan, Jonas M.
dc.contributor.authorTimek, Dana T.
dc.contributor.authorGlantz, Michael J.
dc.contributor.authorSogge, Steven
dc.contributor.authorDimaio, Christopher
dc.contributor.authorMoser, Richard P.
dc.contributor.authorYunus, Shakeeb
dc.contributor.authorFitzgerald, Thomas J.
dc.contributor.authorUpadhyay, Urvashi
dc.contributor.authorRava, Paul
dc.contributor.authorTangel, Matthew
dc.contributor.authorYao, Aaron
dc.contributor.authorKanekar, Sangam
dc.date2022-08-11T08:09:43.000
dc.date.accessioned2022-08-23T16:41:00Z
dc.date.available2022-08-23T16:41:00Z
dc.date.issued2015-11-10
dc.date.submitted2015-10-29
dc.identifier.citationOncotarget. 2015 Nov 10;6(35):38421-8. doi: 10.18632/oncotarget.5376. <a href="http://dx.doi.org/10.18632/oncotarget.5376">Link to article on publisher's site</a>
dc.identifier.issn1949-2553 (Linking)
dc.identifier.doi10.18632/oncotarget.5376
dc.identifier.pmid26472106
dc.identifier.urihttp://hdl.handle.net/20.500.14038/39794
dc.description.abstractBACKGROUND: Many meningiomas are identified by imaging and followed, with an assumption that they are WHO Grade I tumors. The purpose of our investigation is to find clinical or imaging predictors of WHO Grade II/III tumors to distinguish them from Grade I meningiomas. METHODS: Patients with a pathologic diagnosis of meningioma from 2002-2009 were included if they had pre-operative MRI studies and pathology for review. A Neuro-Pathologist reviewed and classified all tumors by WHO 2007. All Brain MRI imaging was reviewed by a Neuro-radiologist. Pathology and Radiology reviews were blinded from each other and clinical course. Recursive partitioning was used to create predictive models for identifying meningioma grades. RESULTS: Factors significantly correlating with a diagnosis of WHO Grade II-III tumors in univariate analysis: prior CVA (p = 0.005), CABG (p = 0.010), paresis (p = 0.008), vascularity index = 4/4: (p = 0.009), convexity vs other (p = 0.014), metabolic syndrome (p = 0.025), non-skull base (p = 0.041) and non-postmenopausal female (p = 0.045). Recursive partitioning analysis identified four categories: 1. prior CVA, 2. vascular index (vi) = 4 (no CVA), 3. premenopausal or male, vi < 4, no CVA. 4. Postmenopausal, vi < 4, no CVA with corresponding rates of 73, 54, 35 and 10% of being Grade II-III meningiomas. CONCLUSIONS: Meningioma patients with prior CVA and those grade 4/4 vascularity are the most likely to have WHO Grade II-III tumors while post-menopausal women without these features are the most likely to have Grade I meningiomas. Further study of the associations of clinical and imaging factors with grade and clinical behavior are needed to better predict behavior of these tumors without biopsy.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=26472106&dopt=Abstract">Link to Article in PubMed</a>
dc.rights<p>All site content, except where otherwise noted, is licensed under a <a href="http://creativecommons.org/licenses/by/3.0/">Creative Commons Attribution 3.0 License</a>.</p>
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/
dc.subjectMRI
dc.subjectcerebrovascular accident
dc.subjectmeningioma
dc.subjecttumor vascularity
dc.subjectNeoplasms
dc.subjectNeurology
dc.subjectOncology
dc.subjectRadiology
dc.titleDistinguishing grade I meningioma from higher grade meningiomas without biopsy
dc.typeJournal Article
dc.source.journaltitleOncotarget
dc.source.volume6
dc.source.issue35
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=3594&amp;context=oapubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/2590
dc.identifier.contextkey7779446
refterms.dateFOA2022-08-23T16:41:00Z
html.description.abstract<p>BACKGROUND: Many meningiomas are identified by imaging and followed, with an assumption that they are WHO Grade I tumors. The purpose of our investigation is to find clinical or imaging predictors of WHO Grade II/III tumors to distinguish them from Grade I meningiomas.</p> <p>METHODS: Patients with a pathologic diagnosis of meningioma from 2002-2009 were included if they had pre-operative MRI studies and pathology for review. A Neuro-Pathologist reviewed and classified all tumors by WHO 2007. All Brain MRI imaging was reviewed by a Neuro-radiologist. Pathology and Radiology reviews were blinded from each other and clinical course. Recursive partitioning was used to create predictive models for identifying meningioma grades.</p> <p>RESULTS: Factors significantly correlating with a diagnosis of WHO Grade II-III tumors in univariate analysis: prior CVA (p = 0.005), CABG (p = 0.010), paresis (p = 0.008), vascularity index = 4/4: (p = 0.009), convexity vs other (p = 0.014), metabolic syndrome (p = 0.025), non-skull base (p = 0.041) and non-postmenopausal female (p = 0.045). Recursive partitioning analysis identified four categories: 1. prior CVA, 2. vascular index (vi) = 4 (no CVA), 3. premenopausal or male, vi < 4, no CVA. 4. Postmenopausal, vi < 4, no CVA with corresponding rates of 73, 54, 35 and 10% of being Grade II-III meningiomas.</p> <p>CONCLUSIONS: Meningioma patients with prior CVA and those grade 4/4 vascularity are the most likely to have WHO Grade II-III tumors while post-menopausal women without these features are the most likely to have Grade I meningiomas. Further study of the associations of clinical and imaging factors with grade and clinical behavior are needed to better predict behavior of these tumors without biopsy.</p>
dc.identifier.submissionpathoapubs/2590
dc.contributor.departmentDepartment of Medicine, Division of Hematology/Oncology
dc.contributor.departmentDepartment of Surgery, Division of Neurosurgery
dc.contributor.departmentDepartment of Medical Oncology
dc.contributor.departmentDepartment of Radiation Oncology
dc.source.pages38421-8


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