ArticleActa neurochirurgica2022
Proposal of a new grading system for meningioma resection: the Copenhagen Protocol.
Article in Acta neurochirurgica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Prognostic Value of Magnetic Resonance Imaging Defined Extent of Surgical Resection in Dogs With Intracranial Meningiomas.Veterinary and comparative oncology · 2026Article
- Laser Confocal Microscopy May Be a Useful Tool in Neuropathological Intraoperative Examination.Diagnostics (Basel, Switzerland) · 2025Article
- Article
- Grading meningioma resections: the Simpson classification and beyond.Acta neurochirurgica · 2024Review
- Postoperative [European journal of nuclear medicine and molecular imaging · 2023Article
- Radiotherapy and radiosurgery for meningiomas.Neuro-oncology advances · 2023Article
- Meningiomas with CNS invasion.Frontiers in neuroscience · 2023Review
- Article
- Review
- The Role of [Cancers · 2022Review
- Management of cavernous sinus meningiomas: Consensus statement on behalf of the EANS skull base section.Brain & spine · 2022Article
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Authors and funding
17 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe extent of meningioma resection is the most fundamental risk factor for recurrence, and exact knowledge of extent of resection is necessary for prognostication and for planning of adjuvant treatment. Currently used classifications are the EANO-grading and the Simpson grading. The former comprises radiological imaging with contrast-enhanced MRI and differentiation between "gross total removal" and "subtotal removal," while the latter comprises a five-tiered differentiation of the surgeon's impression of the extent of resection. The extent of resection of tumors is usually defined via analyses of resection margins but has until now not been implemented for meningiomas. PET/MRI imaging with
objectiveTo develop an objective grading system based on microscopic analyses of resection margins and sensitive radiological analyses to improve management of follow-up, adjuvant therapy, and prognostication of meningiomas. Based on the rationale of resection-margin analyses as gold standard and superior imaging performance of
resultsCopenhagen Grading was described for six pilot patients with examples of positive and negative findings on histopathology and DOTATOC PET scanning. The grading could be traceably implemented and parameters of grading appeared complementary. Copenhagen Grading is prospectively implemented as a clinical standard at Rigshospitalet, Copenhagen.
conclusionCopenhagen Grading provided a comprehensive, logical, and reproducible definition of the extent of resection. It offers promise to be the most sensitive and specific imaging modality available for meningiomas. Clinical and cost-efficacy remain to be established during prospective implementation.
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