Evaluating the role of HR 3D-CBCT and squid 12® embolic agent in meningioma management: Insights from MRI modifications at follow-Up

Abstract

We report three cases of meningiomas treated with Squid 12® with their peculiar technical aspects. High-resolution 3D cone-beam CT angiography (HR 3D-CBCT) was used to evaluate the tumor's vascular anatomy and guide embolization, revealing pial arterial supplies not readily visible on standard angiography. Squid 12® achieved deep tumor penetration, abolishing contrast enhancement on immediate post-procedural MRI. Follow-up MRIs showed progressive tumor shrinkage, with peripheral ring enhancement and decreased edema. Tumor volume was reduced by approximately 50% at the 4-6 months follow-up, leading to a delay in SRS for further stabilization and clinical improvement in the symptomatic patients.

Keywords: EVOH; Endovascular treatment; High-resolution cone-beam CT; Meningioma embolization.