Tesis

Penentuan Meningioma WHO Grade 1 dengan Gambaran Karakteristik pada Magnetic Resonance Imaging Kepala = Determination of WHO Grade I Meningioma Based on Characteristic Features on Brain Magnetic Resonance Imaging.

Pendahuluan: Meningioma merupakan tumor primer intrakranial tersering pada dewasa. MRI menjadi modalitas utama dalam memperkirakan derajat meningioma. Pada kasus tertentu radiosurgery dapat menjadi pilihan tatalaksana, sehingga diagnosis dengan MRI sangat penting dalam menentukan derajat meningioma. Tujuan: Penelitian ini bertujuan untuk menilai korelasi antara MRI kepala dengan hasil histopatologi dan parameter MRI yang berperan dalam mendiagnosis meningioma WHO grade I, Metode: Sebanyak 85 pasien yang didiagnosis meningioma WHO grade I berdasarkan MRI konvensional dan menjalani operasi pertama kali di RSUPN Dr. Cipto Mangunkusumo antara 2018 hingga 2022 dianalisis secara analitik retrospektif. Hubungan antara variabel MRI kepala konvensional dan hasil histopatologinya dinilai secara kuantitatif. Hasil: Adanya hubungan signifikan antara MRI kepala konvensional dan hasil histopatologi dalam menentukan meningioma WHO grade I, namun, antar variablel tidak seluruhnya terbukti signifikan secara statistik pada analisis multivariat, sehingga dilakukan pembentukan skoring klinis mempertimbangkan variabel dengan nilai B koefisien terbesar, sebagai berikut: 11 × (Bentuk bulat/regular) + 2 × (isointens T2) + 2 × (homogenitas pasca kontras) + 2 × (tidak ada kalsifikasi) + 1 x (CSF cleft) + 1 x (Broad base) + 2 x (dural tail), dengan Adjusted R² = 0,85 dan AUC ROC = 0,942 (95% CI 0,862–1,00), menunjukkan kemampuan akurasi tinggi. Cut-off skor ≥10 direkomendasikan sebagai batas optimal untuk identifikasi meningioma WHO grade I dengan sensitivitas dan spesifisitas yang seimbang, sedangkan cut-off >16 dapat digunakan bila diperlukan spesifisitas yang lebih tinggi dalam memastikan diagnosis. Kesimpulan: MRI konvensional dapat memprediksi meningioma WHO grade I dengan menggunakan sistem skoring ini.


Introduction: Meningioma is the most common primary intracranial tumor in adults. MRI is the main modality used to estimate the grade of meningiomas. In certain cases, radiosurgery can be considered as a treatment option; therefore, MRI-based diagnosis is crucial in determining the tumor grade. Objective: This study aims to evaluate the correlation between brain MRI findings and histopathological results, as well as to identify MRI parameters that play a role in diagnosing WHO Grade I meningiomas. Methods: A total of 85 patients who were diagnosed with WHO Grade I meningioma based on conventional MRI and underwent primary tumor resection at Dr. Cipto Mangunkusumo National General Hospital between 2018 and 2022 were retrospectively analyzed. The relationship between conventional brain MRI variables and histopathological results was quantitatively assessed. Results: A significant correlation was found between conventional brain MRI and histopathological outcomes in determining WHO Grade I meningiomas. However, not all variables showed statistical significance in multivariate analysis. Therefore, a clinical scoring system was formulated based on variables with the highest coefficient values, as follows: 11 × (Oval/Regular shape) + 2 × (T2 isointensity) + 2 × (Homogeneous post-contrast enhancement) + 2 × (Absence of calcification) + 1 × (CSF cleft) + 1 × (Broad base) + 2 × (Dural tail), with an Adjusted R² = 0.85 and AUC ROC = 0.942 (95% CI 0.862–1.00), indicating high diagnostic accuracy. A score cut-off ≥10 is recommended as an optimal threshold to identify WHO Grade I meningioma with balanced sensitivity and specificity, while a cut-off >16 may be used when higher specificity is required to confirm the diagnosis. Conclusion: Conventional MRI can reliably predict WHO Grade I meningioma using this proposed scoring system.