title: 3D Volumetric Measurement of Neurofibromatosis Type 2-Associated Meningiomas: Association Between Tumor Location and Growth Rate.
abstract: OBJECTIVE
  Treatment of meningiomas in neurofibromatosis type II (NF2) patients is challenging because the natural history of these tumors is unclear. More insight in tumor growth and factors predicting growth may contribute to a better clinical management. In this study, growth characteristics of supratentorial NF-related meningiomas were examined and the association between tumor growth rate and location was evaluated.
  
  
  METHODS
  In all NF2 patients followed up at the VU University Medical Center, who underwent a minimum of 3 consecutive scans, tumor volumes were assessed by using 3D volumetric measurement (Brainlab, Feldkirchen, Germany). Growth patterns were visually analyzed. To assess the association between tumor growth rate and tumor location, the meningiomas were divided in 3 groups on the basis of their location: skull base, convexity, and "other." Univariable and multivariable logistic regression models were built.
  
  
  RESULTS
  Twenty-one patients (13 females) with a mean (standard deviation) follow-up period of 5.55 (2.48) years and a total of 210 meningiomas were included in the analyses. Tumors followed different growth patterns and did not increase in size simultaneously within 1 patient. Skull base meningiomas had a significantly higher absolute growth rate compared with convexity (β = 0.91, 95% confidence interval [CI] 0.08-1.73) and "other" (β = 1.07, 95% CI 0.27-1.86) and a significantly higher relative growth rate on both linear and geometric growth rate compared with "other" (β = 90.73, 95% CI 5.50-175.95 and β = 18.63, 95% CI 2.94-34.31, respectively) on multivariable logistic regression.
  
  
  CONCLUSIONS
  Within a single patient, NF2-related meningiomas follow different growth patterns. Skull base meningiomas grow faster compared with other locations. Yearly magnetic resonance imaging scans and timely treatment of skull base meningiomas should be considered.
authors.affiliation: Neurosurgical Center Amsterdam, The Netherlands.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Evers
authors.affiliation: Neurosurgical Center Amsterdam, The Netherlands; Meningioma Group Amsterdam, The Netherlands.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Verbaan
authors.affiliation: Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Sanchez
authors.affiliation: Neurosurgical Center Amsterdam, The Netherlands; Meningioma Group Amsterdam, The Netherlands. Electronic address: sm.peerdeman@vumc.nl.
authors.forename: Saskia
authors.initials: S
authors.lastname: Peerdeman
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D016518:Neurofibromatosis 2 / Q000473:pathology* / Q000601:surgery / Q000628:therapy; D059906:Neuroimaging / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D019291:Skull Base / Q000473:pathology / Q000601:surgery
keywords: Meningioma; Neurofibromatosis type II; Oncology; Tumor growth; Volumetric analysis