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Can we predict intraoperative blood loss in meningioma patients? Application of dynamic susceptibility contrast-enhanced magnetic resonance imaging - 24/11/19

Doi : 10.1016/j.neurad.2019.10.003 
Yeonah Kang a, b, Kuo-Chen Wei c, Cheng Hong Toh b,
a Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea 
b Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan 
c Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan 

Corresponding author at: Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan.Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of MedicineTao-YuanTaiwan
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Sunday 24 November 2019
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Resumen

Graphical abstract




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Highlights

Quantitative analysis of meningioma vascularity using dynamic susceptibility contrast (DSC) perfusion MR imaging demonstrates correlations to the estimated blood loss (EBL) during surgery after controlling for the tumor volume.
After leakage correction, the corrected relative CBV (rCBV) and K2 were independent predictors of EBL/cm3, which reflects the inherent tendency of meningiomas to bleed.
The rCBV and K2 derived from DSC perfusion MR imaging in meningiomas may serve as feasible tools for clinicians to predict intraoperative blood loss and facilitate surgical planning.

El texto completo de este artículo está disponible en PDF.

Abstract

Purpose

To evaluate the potential of quantitative dynamic susceptibility contrast (DSC) perfusion MR imaging parameters as imaging biomarkers for predicting intraoperative blood loss in meningioma.

Methods

Fifty-one non-embolized meningioma patients who had undergone preoperative DSC perfusion MR imaging were retrospectively included. The corrected relative cerebral blood volume (rCBV) and leakage coefficient (K2) of the entire enhanced tumor were obtained using leakage correction. Tumor volume, location, grade, and other clinical variables, were also analyzed. To investigate the vascularity and vascular permeability of meningiomas, and their correlation with predicting estimated blood loss (EBL) using preoperative DSC perfusion MR imaging, the authors proposed an index reflecting the inherent tendency of meningiomas to bleed after controlling volume (i.e., EBL/cm3). Simple regression was performed to identify predictors of EBL/cm3; subsequently, the relevant variables included in the stepwise multiple linear regression.

Results

On univariate analysis, EBL/cm3 was correlated with rCBV (r=0.677; P<0.001), K2 (r=0.294; P=0.036), and tumor volume (r=–0.312, P=0.026). EBL/cm3 was not correlated with age (P=0.873), sex (P=0.404), tumor location (P=0.327), or histological grade (P=0.230). On multiple linear regression, rCBV (β=0.663 [0.463–0.864], B=1.293 [0.903–1.684; P<0.001) and K2 (β=0.260 [0.060–0.460], B=2.277 [0.523–4.031], P=0.012), were the only independent predictors of EBL/cm3.

Conclusion

The rCBV and K2 derived from DSC perfusion MR imaging in meningiomas may serve as feasible tools for clinicians to predict intraoperative blood loss and facilitate surgical planning.

El texto completo de este artículo está disponible en PDF.

Keywords : Meningioma, Magnetic Resonance Imaging, Perfusion imaging, surgical blood loss, oncology

Abbreviations : DSC, EBL, rCBV, K2, T1WI, FLAIR


Esquema


 This study has received a grant from National Science Council Taiwan (NSC-102-2314-B-182-055 to Cheng Hong Toh).


© 2019  Elsevier Masson SAS. Reservados todos los derechos.
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