Postoperative Imaging and Follow-Up of Vestibular Schwannomas

Abstract

There remains no standard postoperative imaging algorithm for patients after complete vestibular schwannoma resection.

Diagnostic Accuracy of the Constructive Interference in Steady State Sequence Alone for Follow-Up Imaging of Vestibular Schwannomas

“…Despite the benign course of VS, the classic management of these lesions has been traditionally surgical. 29 However, with the development of imaging and radiation treatment technologies, radiologic observation with serial imaging studies or treatment with stereotactic radiation therapy (such as gamma knife surgery) has become an acceptable alternative. 5,6,[23][24][25]27,28,30 The radiologic surveillance is especially preferred in elderly patients, in patients with small tumor size or with minimal symptoms, and in patients who are poor surgical candidates.…”

“…5,9,25 In addition, possible recurrence or growth of a residual tumor following VS surgery is also monitored with contrast-enhanced MR imaging. 29,31 Although the postcontrast images are routinely obtained for each of the above-mentioned circumstances and in every single subsequent fol- low-up study, the necessity of contrast use in follow-up imaging has never been questioned. The gadolinium compounds that are used as contrast agents in MR imaging are substances with potential side effects and risk of allergies.…”

Magnetic resonance imaging surveillance following vestibular schwannoma resection

“…Given a lack of early exam findings following surgery and poor correlation between tumor growth and symptoms,2–4 postoperative imaging remains critical to the early identification of recurrent tumor. However, there is no consensus regarding an optimal postoperative magnetic resonance imaging (MRI) surveillance schedule, with practices ranging from several imaging studies within the first year5 to a single postoperative study at 5 years 6…”

Nodular enhancement within the internal auditory canal following retrosigmoid vestibular schwannoma resection: a unique radiological pattern

“…13 We typically obtain a baseline MR image approximately 3 months following GTR and then again at 2 and 7 years to try to capture any early or late tumor recurrence. If the 7-year MR imaging study appears satisfactory, in young patients we recommend a follow-up MR imaging 1 decade thereafter.…”