Background In preoperative embolization for intracranial meningioma, endovascular intratumoral embolization is considered to be more effective for the reduction of tumorous vascularity than proximal feeder occlusion. In this study, we aimed to reveal different efficacies for reducing tumor blood flow in meningiomas by comparing endovascular intratumoral embolization and proximal feeder occlusion using dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI).
Methods 28 consecutive patients were included. DSC-PWI was performed before and after embolization for intracranial meningiomas. Normalized tumor blood volume (nTBV) of voxels of interest of whole tumors were measured from the DSC-PWI data before and after embolization. ΔnTBV% was compared between the cases that received intratumoral embolization and proximal feeder occlusion.
Results ΔnTBV% in the intratumoral embolization group (42.4±29.8%) was higher than that of the proximal feeder occlusion group (15.3±14.3%, p=0.0039). We used three types of embolic materials and ΔnTBV% did not differ between treatments with or without the use of each material: 42.8±42.4% vs 28.7±20.1% for microspheres (p=0.12), 36.1±20.6% vs 28.1±41.1% for n-butyl cyanoacrylate (p=0.33), and 32.3±37.3% vs 34.1±19.0% for bare platinum coils (p=0.77).
Conclusions The flow reduction effect of intratumoral embolization was superior to that of proximal feeder occlusion in preoperative embolization for intracranial meningioma in an assessment using DSC-PWI.
- MR perfusion
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Contributors Concept and study design: KA, HN, YW, MK and HK. Data acquisition and analysis: KA, HN, YW, TK, MS, AA, MT, HA, TO, YF, KN and MK. Drafting of the manuscript and figures: KA, HN, MK and HK. Review and editing of the manuscript: all authors.
Funding This work was supported by the Japanese Society for Neuroendovascular Therapy grant number.
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval This study was approved by the ethics committee of the local institutional review boards of Osaka University Hospital (approval number: 14184) and Osaka International Cancer Institute (approval number: 1503315260).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.
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