A new study has shown that a clinical tool developed by the University of Liverpool and The Walton Centre can accurately predict whether the most common type of brain tumour will grow or cause symptoms, helping doctors and patients make better-informed decisions about care.
Meningiomas, which account for around 3,500 new cases in the UK each year, are often discovered by chance during brain scans. While most never cause harm, some eventually require surgery or other treatment. Until now, it has been difficult to know which patients will be affected, leading to years of unnecessary monitoring for some and delayed treatment for others.
Researchers developed the IMPACT tool in 2019 based on data from around 400 patients under neurosurgical care at The Walton Centre NHS Foundation Trust in Liverpool. The tool considers the patient’s comorbidities, functional status and imaging characteristics of the tumour, to work out the risk of tumour progression, and need for treatment. The tool has now been tested on more than 1,200 patients from 33 hospitals across 15 countries, with follow-up periods of up to 15 years. The results showed that patients could be reliably grouped into low, medium, or high risk of tumour progression.
Low-risk patients were found to have only a one in twenty-five chance of needing treatment, while the risk was one in four for medium-risk patients and one in two for those in the high-risk group. Most progression was seen within the first five years, while older or frailer patients were found to be very unlikely ever to require treatment.
Dr Abdurrahman Islim, study co-lead, former Honorary Research Fellow at the University of Liverpool and currently a Neurosurgery Registrar and PhD Fellow, University of Manchester & Salford Royal Hospital (part of Northern Care Alliance NHS Foundation Trust), said: “This study is an important step forward in personalising care for people with meningiomas. 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.”
The findings suggest that high-risk patients may benefit from early intervention, medium-risk patients should continue regular monitoring, and many low-risk patients could be safely discharged with advice on what symptoms to look out for.
Study lead, Professor of Neurosurgery at the University of Liverpool & Consultant neurosurgeon at The Walton Centre, Michael Jenkinson added: “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 personalised care will bring not only health benefits to patients but also cost savings to the NHS and wider economic growth.”
Shelli Koszdi, a co-author of the study and a patient representative said: “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 paper, ‘A Clinical Tool to Identify Incidental Meningioma for Early Outpatient Management’, was published in JAMA Oncology (DOI:10.1001/jamaoncol.2025.4821).