PURPOSE: Radiation-induced meningioma is a known late effect of cranial 
radiation therapy. Cranial magnetic resonance imaging (MRI) can detect small 
meningiomas, but its potential value as a screening tool is unknown.
METHODS AND MATERIALS: MRI was used to screen asymptomatic survivors of 
childhood acute lymphoblastic leukemia (ALL) treated with cranial radiation 
therapy ≥10 years previously. The incidence of radiation-induced meningioma and 
outcomes of this group were compared with a historical cohort of survivors with 
the same exposure who underwent imaging only to investigate clinical signs or 
symptoms.
RESULTS: One hundred seventy-six childhood leukemia survivors were included in 
this study: 70 in the screening group and 106 unscreened. Screening MRI was 
performed a median of 25 years after radiation therapy and detected meningioma 
in 15 (21.4%). In the unscreened group, 17 patients (16.0%) had neurologic 
symptoms leading to an MRI a median interval of 24 years after radiation 
therapy, 9 of whom (8.5%) were diagnosed with meningioma. There was no 
significant difference between screened versus unscreened patients in the size 
of meningioma (mean diameter, 1.6 cm vs 2.6 cm; P = .13), meningioma incidence 
(7.4% vs 4.0% at 25 years; P = .19), or extent of resection. Three patients had 
persistent neurologic symptoms in the unscreened group versus none among 
screened patients (P = .28).
CONCLUSIONS: Screening MRI was able to detect small meningiomas that were not 
clinically apparent; however, we could not demonstrate a significant improvement 
in the chance of total resection or a significant decrease in morbidity. A 
larger sample could clarify potential reduction in neurologic sequelae 
associated with screening.