Jayson L Co1, Monali Swain2, Louise J Murray3, Sameera Ahmed1, Normand J Laperriere1, Derek S Tsang1, Eugene Yu4, Melania Pintilie5, Jessica Weiss5, David C Hodgson6. 1. Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada. 2. Radiation Oncology, Tata Memorial Hospital, Mumbai, India. 3. Radiotherapy Research Group, St James's University Hospital and University of Leeds, Leeds, UK. 4. Radiology and Medical Imaging, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada. 5. Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada. 6. Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada; Pediatric Oncology Group of Ontario (POGO), Toronto, Ontario, Canada. Electronic address: david.hodgson@rmp.uhn.ca.
Abstract
PURPOSE: Radiation-induced meningioma is a known late effect of cranial radiation therapy. Cranial magnetic resonance imaging (MRI) can detect small meningiomas, but its potential value as a screening tool is unknown. METHODS AND MATERIALS: MRI was used to screen asymptomatic survivors of childhood acute lymphoblastic leukemia (ALL) treated with cranial radiation therapy ≥10 years previously. The incidence of radiation-induced meningioma and outcomes of this group were compared with a historical cohort of survivors with the same exposure who underwent imaging only to investigate clinical signs or symptoms. RESULTS: One hundred seventy-six childhood leukemia survivors were included in this study: 70 in the screening group and 106 unscreened. Screening MRI was performed a median of 25 years after radiation therapy and detected meningioma in 15 (21.4%). In the unscreened group, 17 patients (16.0%) had neurologic symptoms leading to an MRI a median interval of 24 years after radiation therapy, 9 of whom (8.5%) were diagnosed with meningioma. There was no significant difference between screened versus unscreened patients in the size of meningioma (mean diameter, 1.6 cm vs 2.6 cm; P = .13), meningioma incidence (7.4% vs 4.0% at 25 years; P = .19), or extent of resection. Three patients had persistent neurologic symptoms in the unscreened group versus none among screened patients (P = .28). CONCLUSIONS: Screening MRI was able to detect small meningiomas that were not clinically apparent; however, we could not demonstrate a significant improvement in the chance of total resection or a significant decrease in morbidity. A larger sample could clarify potential reduction in neurologic sequelae associated with screening.
PURPOSE: Radiation-induced meningioma is a known late effect of cranial radiation therapy. Cranial magnetic resonance imaging (MRI) can detect small meningiomas, but its potential value as a screening tool is unknown. METHODS AND MATERIALS: MRI was used to screen asymptomatic survivors of childhood acute lymphoblastic leukemia (ALL) treated with cranial radiation therapy ≥10 years previously. The incidence of radiation-induced meningioma and outcomes of this group were compared with a historical cohort of survivors with the same exposure who underwent imaging only to investigate clinical signs or symptoms. RESULTS: One hundred seventy-six childhood leukemia survivors were included in this study: 70 in the screening group and 106 unscreened. Screening MRI was performed a median of 25 years after radiation therapy and detected meningioma in 15 (21.4%). In the unscreened group, 17 patients (16.0%) had neurologic symptoms leading to an MRI a median interval of 24 years after radiation therapy, 9 of whom (8.5%) were diagnosed with meningioma. There was no significant difference between screened versus unscreened patients in the size of meningioma (mean diameter, 1.6 cm vs 2.6 cm; P = .13), meningioma incidence (7.4% vs 4.0% at 25 years; P = .19), or extent of resection. Three patients had persistent neurologic symptoms in the unscreened group versus none among screened patients (P = .28). CONCLUSIONS: Screening MRI was able to detect small meningiomas that were not clinically apparent; however, we could not demonstrate a significant improvement in the chance of total resection or a significant decrease in morbidity. A larger sample could clarify potential reduction in neurologic sequelae associated with screening.
Authors: Lisanne C Verbruggen; Melissa M Hudson; Daniel C Bowers; Cécile M Ronckers; Gregory T Armstrong; Roderick Skinner; Eelco W Hoving; Geert O Janssens; Helena J H van der Pal; Leontine C M Kremer; Renée L Mulder Journal: J Neurooncol Date: 2020-02-22 Impact factor: 4.130
Authors: Umberto Tosi; Omri Maayan; Anjile An; Miguel E Tusa Lavieri; Sergio W Guadix; Antonio P DeRosa; Paul J Christos; Susan Pannullo; Philip E Stieg; Andrew Brandmaier; Jonathan P S Knisely; Rohan Ramakrishna Journal: J Neurooncol Date: 2022-01-18 Impact factor: 4.130
Authors: Conor S Gillespie; Abdurrahman I Islim; Basel A Taweel; Christopher P Millward; Siddhant Kumar; Nitika Rathi; Shaveta Mehta; Brian J Haylock; Nicola Thorp; Catherine E Gilkes; David D A Lawson; Samantha J Mills; Emmanuel Chavredakis; Jibril Osman Farah; Andrew R Brodbelt; Michael D Jenkinson Journal: J Neurooncol Date: 2021-04-22 Impact factor: 4.130