From the Research
Meningiomas on MRI should be managed with stereotactic radiosurgery as the primary treatment for skull base meningiomas with high surgical risk, as it provides high tumor control rates and low adverse radiation events, as evidenced by the most recent study [ 1 ]. Meningiomas typically appear as well-defined, extra-axial masses on MRI, with characteristic imaging features including a broad dural base, clear cerebrospinal fluid cleft, and calcifications. The imaging characteristics help differentiate meningiomas from other intracranial masses. While most meningiomas are benign, certain imaging features may suggest higher-grade variants that require more aggressive management. Some key points to consider in the management of meningiomas include:
- The location of the tumor, with skull base meningiomas being particularly challenging to treat surgically [ 2 ]
- The use of stereotactic radiosurgery as a primary treatment for small asymptomatic meningiomas, which is increasingly being investigated [ 1 ]
- The importance of individualized management based on patient comorbidities, tumor location and characteristics, symptomatic burden, and patient age [ 1 ]
- The potential for advances in genomics and molecular characteristics to improve grading and prediction of prognosis and recurrence [ 3 ]