New Tool Predicts Brain Tumor Treatment Needs with High Accuracy

A groundbreaking study led by the University of Liverpool and The Walton Center has introduced a clinical tool that can accurately predict whether patients with meningiomas, the most common type of brain tumor, will require treatment. This development aims to enhance decision-making for both doctors and patients, ultimately improving patient care.

Meningiomas account for approximately 3,500 new cases annually in the U.K. These tumors are often discovered incidentally during brain scans, and while most remain harmless, a subset necessitates surgical intervention or other treatments. Historically, determining which patients would require action has been challenging, resulting in years of unnecessary monitoring for some individuals, while others faced delays in receiving timely care.

The newly developed tool, named IMPACT, was created in 2019 and is based on data from roughly 400 patients receiving neurosurgical care at The Walton Center NHS Foundation Trust in Liverpool. The IMPACT tool evaluates a patient’s comorbidities, functional status, and the imaging characteristics of the tumor to assess the risk of tumor progression and the potential need for treatment.

Comprehensive Testing Across Multiple Countries

The effectiveness of the IMPACT tool has been validated through testing on over 1,200 patients across 33 hospitals in 15 countries, with follow-up periods extending up to 15 years. The study’s findings indicate that patients can be classified into low, medium, or high risk of tumor progression. Specifically, low-risk patients have only a 1 in 25 chance of requiring treatment, while medium-risk patients face a 1 in 4 risk, and high-risk individuals have a 1 in 2 likelihood of needing intervention. Most tumor progression occurs within the first five years, and older or frailer patients are less likely to require treatment.

Dr. Abdurrahman Islim, co-lead of the study and a Neurosurgery Registrar and Ph.D. Fellow at the University of Manchester and Salford Royal Hospital, emphasized the significance of the study in personalizing care for meningioma patients. He stated, “For the first time, we can give patients with an incidental meningioma clear answers about their individual risk, helping avoid unnecessary scans for some, while ensuring that others get timely treatment.”

Implications for Patient Care and Healthcare Costs

The findings suggest tailored approaches for different patient groups. High-risk patients may benefit from early intervention, while medium-risk patients should continue regular monitoring. Many low-risk patients could be safely discharged with guidance on symptoms to monitor.

Michael Jenkinson, a Professor of Neurosurgery at the University of Liverpool and a Consultant Neurosurgeon at The Walton Center, highlighted the next steps for the IMPACT tool. He said, “It’s important that now we test the IMPACT tool in real-time with patients in clinics, with funding being sought to bring it into routine practice. The ability to offer personalized care will bring not only health benefits to patients but also cost savings to the NHS and wider economic growth.”

Patient representative Shelli Koszdi, who co-authored the study, shared her personal experience. “As a patient, I had already chosen observation in consultation with my neurosurgeon, and the IMPACT model helped reassure me I had made the right decision and enabled me to push thoughts of the meningioma into the background and move on with my life in what could have been a very anxiety-producing situation.”

The study, titled “A Clinical Tool to Identify Incidental Meningioma for Early Outpatient Management,” was published in JAMA Oncology. The research marks a significant advancement in the field of neurosurgery and patient management, promising to refine treatment pathways and improve quality of life for those affected by meningiomas.