Can cerebral flow estimated from 3D pCASL predict intraoperative blood loss in non-embolized meningioma? A feasibility study

Motivation: Preoperative identification of hyper-vascular meningiomas is essential to inform and improve surgery planning. Goal(s): Investigating if cerebral flow (CBF) estimated from 3D pCASL could be used to preoperatively predict intraoperative estimated blood loss (EBL) in meningiomas patients. Approach: 48 pathologically confirmed non-embolized meningiomas patients were retrospectively selected. They received routine MRI examination and were additionally imaged with 3D pCASL before surgery. CBF and MRI provided anatomical information of tumor were analyzed. Results: Both the relative CBF and the volume ratio between tumor and total brain (VRTB) can independently differentiate low from high EBL meningiomas and their combination can further improve the prediction performance. Impact: The rCBF and VRTB may serve as promising non-invasive imaging biomarkers to preoperatively predict EBL and guide meningioma surgery planning.