• World Neurosurg · Oct 2021

    Clinical characteristics and MRI-based prediction of the KLF4K409Q-mutation in meningioma.

    • Niklas von Spreckelsen, Natalie Waldt, Marco Timmer, Lukas Goertz, David Reinecke, Kai Laukamp, Lenhard Pennig, Stefan Grau, Martina Deckert, Elmar Kirches, Pantelis Stavrinou, Christian Mawrin, and Roland Goldbrunner.
    • Department of Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany; Department of Neuropathology, Otto-von-Guericke University, Magdeburg, Germany. Electronic address: niklas.von-spreckelsen@uk-koeln.de.
    • World Neurosurg. 2021 Oct 1; 154: e665-e670.

    BackgroundMeningioma is the most common primary brain tumor in adults. In recent years, several non-neurofibromin 2 mutations, i.e., AKT1, SMO, TRAF7, and KLF4 mutations, specific for meningioma have been identified. This study aims to analyze the clinical impact and imaging characteristics of the KLF4K409Q mutation in meningioma.MethodsClinical, neuropathologic, and imaging data of 170 patients who underwent meningioma resection between 2013 and 2018 were retrospectively collected and tumors were analyzed for the presence of the KLF4K409Q mutation. We collected imaging characteristics, performed volumetric analysis of tumor size and peritumoral edema (PTBE), and calculated the edema index (EI, i.e., ratio of PTBE to tumor volume). Receiver operating characteristic curve analysis was performed to identify cut-off EI values to predict the mutational status of KLF4.ResultsEighteen (10.6%) of the meningiomas carried the KLF4K409Q mutation; these were significantly associated with a secretory subtype (P < 0.001) and sphenoid wing location (P = 0.029). Smaller tumor size (P = 0.007), an increased PTBE (P = 0.012), and an increased EI (P = 0.001) proved to be significantly associated with the KLF4K409Q mutation. In receiver operating characteristic curve analysis, EI predicted the KLF4K409Q mutation with an area under the curve of 0.728 (P = 0.0016).ConclusionsThe KLF4K409Q mutation is associated with a distinct small tumor subtype, prone to substantial PTBE. EI is a reliable parameter to predict the KLF4K409Q mutation in meningioma, thus providing a tool for improvement of pre- and perioperative medical management.Copyright © 2021 Elsevier Inc. All rights reserved.

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