Preoperative Evaluation of Tumor Adhesion to Adjacent Brain Tissue in Patients with Meningioma with BSMI Method and Its Comparison with the Width of Edema Around Tumor

Abstract

Background: This study aims to investigate the ability of BSMI, to preoperative evaluation of tumor adhesion to<br />adjacent brain tissue in patients with meningioma and comparing this method to the width of edema around tumor, using<br />surgery findings as the reference standard. Methods: Thirty patients with meningioma brain tumor who underwent<br />surgery at Loghman hospital were selected for the study between November 2016 and January 2018. The level of<br />edema according to the classification of Ide et al., (u1995) was compared with the surgical findings with blinded results,<br />and neurosurgeons made a qualitative assessment of tumor adhesion at the time of resection. The ability of BSMI and<br />level of edema to predict the surgical assessment of adhesion was tested using the Fisher Exact Test. Results: BSMI<br />method was conducted on patients with meningioma brain tumor, which judged 22 (73.3%) patients as adhesion (+)<br />and 8 (26.66%) patients as adhesion (-). In this case, there was a significant relationship between BSMI judgment and<br />surgical findings (p-value<0.0001). The sensitivity, specificity, precision and accuracy was high, at 91.30%, 85.71%,<br />95.45% and 90%, respectively. Using T2-Weighted SPACE sequence, of the 30 patients, 13 (43.3%) were judged as<br />adhesion (+) and 17 (56.7%) as adhesion (-) from edema, whereas surgical findings evaluated 23 (76.7%) as adhesion<br />(+) and 7 (23.3%) as adhesion (-).The sensitivity was moderate but the specificity was high, at 52.17% and 85.71%,<br />respectively. Other criteria such as precision and accuracy were 62.31% and 60%, respectively. Conclusions: BSMI<br />evaluated adhesion of the tumor to the adjacent brain tissue with high-accuracy prior to surgery. This method was more<br />effective than Edema method in evaluating adhesion between meningioma and the brain.