title: A national survey of the management of patients with incidental meningioma in the United Kingdom.
abstract: BACKGROUND
  Incidental meningiomas are increasingly being diagnosed due to widespread use of brain imaging. Treatment options include surveillance, surgery and stereotactic radiosurgery, but the natural history of these tumours is not fully understood and there are no accepted management guidelines to aid clinical decision-making. The aim of this study was to assess current practice in the United Kingdom and identify areas of variation for further study.
  
  
  METHODS
  A questionnaire was distributed to all members of the Society of British Neurosurgeons (SBNS). The main components of the survey included the assessment of which factors and tumour characteristics are considered in the management and follow-up of incidental meningiomas. Two case scenarios were also presented.
  
  
  RESULTS
  The response rate was 12.5% (44 completed surveys) with 74% (25/34) of neurosurgical centres represented. Absence of calcification was only considered by 36% (16/44) of neurosurgeons. Most neurosurgeons opt for surveillance at initial presentation, and the length of follow-up was 5 years (14/33) and 10 years (11/33). The case scenarios highlighted that tumour growth at follow-up resulted in a preference to change from surveillance to treatment with surgery or SRS. SRS was preferred in skull-base (23/36) and medial sphenoid wing (16/39) tumours.
  
  
  CONCLUSIONS
  This survey has demonstrated that certain aspects of incidental meningioma management show variation and remain controversial. Further research through prospective cohort studies is required to provide evidence to support guidelines for the management of incidental meningiomas.
authors.affiliation: a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool , UK.
authors.forename: Mujtaba H
authors.initials: MH
authors.lastname: Mohammad
authors.affiliation: a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool , UK.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chavredakis
authors.affiliation: a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool , UK.|b Institute of Integrative Biology, University of Liverpool , Liverpool , UK.
authors.forename: Rasheed
authors.initials: R
authors.lastname: Zakaria
authors.affiliation: a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool , UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Brodbelt
authors.affiliation: a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool , UK.|c Institute of Translational Medicine, University of Liverpool , Liverpool , UK.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Jenkinson
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D001921:Brain / Q000473:pathology; D002114:Calcinosis / Q000601:surgery; D000066491:Clinical Decision-Making; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D000069471:Neurosurgeons / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011446:Prospective Studies; D016634:Radiosurgery / Q000379:methods / Q000706:statistics & numerical data; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery; D013100:Sphenoid Bone; D013531:Surgicenters / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D006113:United Kingdom
keywords: MRI; Meningioma; incidental; management