Magnetic resonance imaging dynamics of contrast medium uptake in vestibular schwannomas

Rampp, Stefan; Scheller, Christian; Prell, Julian; Engelhorn, Tobias; Strauß, Christian; Rachinger, Jens

doi:10.3171/2010.5.jns10307

Cited by 2 publications

(2 citation statements)

References 28 publications

(37 reference statements)

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“…Our data are in line with the second hypothesis, because the positive correlation between tumor size and EES volume was lost in cystic VSs, the mean Ve being 53% lower in the cystic portions than in the solid portions. In previous studies, the non-enhancing (cystic) portions of VSs have been shown to decrease significantly over time, with slow contrast uptake in up to 90% of the cystic portions ( 34 ) , further confirming that cystic portions have different contrast uptake dynamics and that the cysts are cellular rather than liquid cavities, which explains the differences we found between the cystic and solid portions of cystic VSs in terms of perfusion and EES volume.…”

Section: Discussionsupporting

confidence: 85%

Perfusion-weighted imaging in vestibular schwannoma: the influence that cystic status and tumor size have on perfusion profiles

et al. 2023

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Objective: The perfusion profile of vestibular schwannomas (VSs) and the factors that influence it have yet to be determined. Materials and Methods: Twenty patients with sporadic VS were analyzed by calculating parameters related to the extravascular extracellular space (EES)—the volume transfer constant between a vessel and the EES (Ktrans); the EES volume per unit of tissue volume (Ve); and the rate transfer constant between EES and blood plasma (Kep)—as well as the relative cerebral blood volume (rCBV), and by correlating those parameters with the size of the tumor and its structure (solid, cystic, or heterogeneous). Results: Although Ktrans, Ve, and Kep were measurable in all tumors, rCBV was measurable only in large tumors. We detected a positive correlation between Ktrans and rCBV (r = 0.62, p = 0.031), a negative correlation between Ve and Kep (r = –0.51, p = 0.021), and a positive correlation between Ktrans and Ve only in solid VSs (r = 0.64, p = 0.048). Comparing the means for small and large VSs, we found that the former showed lower Ktrans (0.13 vs. 0.029, p < 0.001), higher Kep (0.68 vs. 0.46, p = 0.037), and lower Ve (0.45 vs. 0.83, p < 0.001). The mean Ktrans was lower in the cystic portions of cystic VSs than in their solid portions (0.14 vs. 0.32, p < 0.001), as was the mean Ve (0.37 vs. 0.78, p < 0.001). There were positive correlations between the solid and cystic portions for Ktrans (r = 0.71, p = 0.048) and Kep (r = 0.74, p = 0.037). Conclusion: In VS, tumor size appears to be consistently associated with perfusion values. In cystic VS, the cystic portions seem to have lower Ktrans and Ve than do the solid portions.

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Section: Discussionsupporting

confidence: 85%

Perfusion-weighted imaging in vestibular schwannoma: the influence that cystic status and tumor size have on perfusion profiles

et al. 2023

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“…When the tumor increased, MRI was performed at 6-month intervals. The same protocol of T1-weighted MR imaging with standard timing of gadolinium injection was applied for image acquisition during the radiosurgical procedure and all follow-up MR imaging, to avoid changes in contrast enhancement due to variations in timing of injection and acquisition [3]. Evolution of the tumor volume and changes in contrast enhancement of the tumor were assessed on MR images co-registered on the follow-up module of Leksell GammaPlan 9.0.…”

Section: Radiosurgery Techniquementioning

confidence: 99%

MRI Changes in Failed Radiosurgery for Vestibular Schwannomas

Massager

Renier²

2022

Stereotact Funct Neurosurg

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Introduction: Radiosurgery is now a recognized treatment of vestibular schwannoma (VS); however, radiosurgical irradiation sometimes fails to stop tumor growth in the long term. Some changes in MR imaging after radiosurgery that are supposed to be related to permanent tumor control may be observed in patients with failed treatment. The objective of the present study was to evaluate the MRI changes observed early after radiosurgery in a cohort of patients with failed radiosurgery for VS. Methods: From a large series of VS treated radiosurgically for 15 years, we reviewed the follow-up MRI data in a subgroup of VS that presented obvious treatment failure. T1-weighted MR imaging with standard timing of gadolinium injection was applied for image acquisition during the radiosurgical procedure and all follow-up MR imaging. Evolution of tumor volume and contrast enhancement were assessed on 3D-co-registered MRI. Results: Twenty-nine of 728 patients (4%) were retreated for the same VS after >2 years (median 3.14 years, range 2.04–9.47) following initial radiosurgical treatment. The median tumor volume was 0.94 cc at first radiosurgical treatment and 2.19 cc at retreatment. Fourteen patients (48.3%) had continuous increase in tumor volume. For 10 patients (34.5%), the tumor volume reduced significantly after irradiation before it increased again. Four patients (13.8%) showed a transient increase in tumor volume after irradiation, followed by significant volume reduction, then a very significant tumor regrowth. A significant loss of contrast enhancement at the center of the tumor was observed for 25 patients (86.2%); full recovery of contrast enhancement of the tumor was observed for 23 patients. Discussion/Conclusion: Tumor volume reduction and central loss of contrast enhancement of the tumor are MRI changes frequently observed during follow-up of VS treated radiosurgically even in patients with failed long-term tumor control and may therefore not be considered as signs of successful response of the tumor to the radiosurgical treatment.

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Magnetic resonance imaging dynamics of contrast medium uptake in vestibular schwannomas

Cited by 2 publications

References 28 publications

Perfusion-weighted imaging in vestibular schwannoma: the influence that cystic status and tumor size have on perfusion profiles

Perfusion-weighted imaging in vestibular schwannoma: the influence that cystic status and tumor size have on perfusion profiles

MRI Changes in Failed Radiosurgery for Vestibular Schwannomas

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