Incidence, management, and outcome of incidental meningioma – what has happened in 10 years?

Abstract

Abstract Purpose The aim of this study was to study the use of brain scanning, and the subsequent findings of presumed incidental meningioma in two time periods, and to study differences in follow-up, treatment, and outcome. Methods Records of performed CT and MRI of the brain were retrospectively reviewed in search for patients with presumed incidental meningioma. Their medical health records were the used to study clinical handling and outcome. Results An identical number of unique patients underwent brain imaging during the two time periods (n = 22 259 vs. 22 013). In 2018–2019, 25% more incidental meningiomas were diagnosed compared to 2008–2009 (n = 161 vs. 129, p = 0.052). MRI was used more often in 2018–2019 (34.8 vs. 28.5%), and the use of contrast enhancement, irrespective of modality, also increased (28.6 vs. 12.2%). In the most recent cohort, patients were older (median 79 years vs. 73 years, p = 0.03). Indications showed a significant increase of cancer without known metastases among scanned patients. Conclusions Despite the same number of unique patients undergoing brain scans in the time periods, there was a trend towards more patients diagnosed with an incidental asymptomatic meningioma in the more recent years. This difference may be attributed to more contrast enhanced scans and more scans among the elderly. Patients in the cohort from 2018–2019 more often had non-metastatic cancer, with their cause of scan screening for metastases. There was no significant difference in management decision at diagnosis, but within 3 years of follow up significantly more patients in the latter cohort had been re-scanned.