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

Document Type : Research Articles


1 Department of Radiology, School of Allied Medical Science, Shahid Beheshti University of Medical Science,Tehran, Iran.

2 School of Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran.

3 Department of Radiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran.


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


Main Subjects