Tumor-Volume Changes after Radiosurgery for Vestibular Schwannoma: Implications for Follow-Up MR Imaging Protocol

Meijer, Otto W.M.; Weijmans, E.J.; Knol, Dirk L.; Slotman, Ben J.; Barkhof, Frederik; Vandertop, W. Peter; Castelijns, Jonas A.

doi:10.3174/ajnr.a0969

Cited by 77 publications

(74 citation statements)

References 30 publications

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“…On the second MR imaging, the mass demonstrated increased volume with increased heterogeneity and necrosis, likely representing the temporary enlargement (or transient swelling) in response to radiation treatment. [37][38][39] The change in internal structure was much better appreciated on the postcontrast images than on the CISS sequence (Fig 4). The overall increase in size of the mass was accepted as progression by the first observer during the qualitative assessment when indeed it may have reflected a positive response to treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The overall increase in size of the mass was accepted as progression by the first observer during the qualitative assessment when indeed it may have reflected a positive response to treatment. [37][38][39] This finding demonstrates that the noncontrast CISS-only approach may be of limited value in the evaluation of patients following radiation treatment.…”

Section: Discussionmentioning

confidence: 99%

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

Özgen¹,

Oğuz²,

Dolgun³

2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Vestibular schwannoma (VS) is a benign, slow-growing tumor, and radiologic monitoring is an acceptable alternative to surgery in small lesions and in elderly patients. MR imaging with contrast is the study of choice in the follow-up of these lesions. However, gadoliniumbased contrast agents have side effects and should be used only when definitely indicated. The purpose of this study was to evaluate the diagnostic accuracy of the constructive interference in steady state (CISS) sequence used without postcontrast sequences for the follow-up imaging of VS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Özgen¹,

Oğuz²,

Dolgun³

2009

AJNR Am J Neuroradiol

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“…With regard to tumor volume, transient enlargement is observed in 30%-41% of patients, no change or sustained regression in 34%-82%, alternating enlargement and regression in 13%, and continuous enlargement in 12%-16%. 13,16 Transient enlargement generally occurs within 2 years after radiosurgery and is often followed by regression. 13,16 Changes in tumor enhancement characteristics include transient loss of enhancement in 84% of patients (Fig.…”

Section: Stereotactic Radiosurgerymentioning

confidence: 99%

“…13,16 Transient enlargement generally occurs within 2 years after radiosurgery and is often followed by regression. 13,16 Changes in tumor enhancement characteristics include transient loss of enhancement in 84% of patients (Fig. 18), continuous increase in enhancement in 5%, and no change in enhancement in 11%.…”

Section: Stereotactic Radiosurgerymentioning

confidence: 99%

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Postoperative imaging of vestibular schwannomas

Ginat¹,

Martuza

2012

FOC

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Symptomatic vestibular schwannomas can be treated with resection (translabyrinthine, retrosigmoid [suboccipital], or middle cranial fossa approaches) or stereotactic radiosurgery. When appropriate, auditory brainstem stimulators can also be implanted in patients with current or impending hearing loss due to bilateral vestibular schwannomas. Imaging plays a prominent role in determining management following these procedures. In this article, the expected postoperative imaging appearances are depicted. The radiological features of complications are also reviewed, including recurrent tumor, fat graft necrosis, CSF leakage, infection, hydrocephalus, cerebral infarction, venous sinus thrombosis, hemorrhage, and temporal lobe and cerebellar contusions.

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Prediction of transient tumor enlargement using MRI tumor texture after radiosurgery on vestibular schwannoma

et al. 2020

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Purpose: Vestibular schwannomas (VSs) are uncommon benign brain tumors, generally treated using Gamma Knife radiosurgery (GKRS). However, due to the possible adverse effect of transient tumor enlargement (TTE), large VS tumors are often surgically removed instead of treated radiosurgically. Since microsurgery is highly invasive and results in a significant increased risk of complications, GKRS is generally preferred. Therefore, prediction of TTE for large VS tumors can improve overall VS treatment and enable physicians to select the most optimal treatment strategy on an individual basis. Currently, there are no clinical factors known to be predictive for TTE. In this research, we aim at predicting TTE following GKRS using texture features extracted from MRI scans. Methods: We analyzed clinical data of patients with VSs treated at our Gamma Knife center. The data was collected prospectively and included patient-and treatment-related characteristics and MRI scans obtained at day of treatment and at follow-up visits, 6, 12, 24 and 36 months after treatment. The correlations of the patient-and treatment-related characteristics to TTE were investigated using statistical tests. From the treatment scans, we extracted the following MRI image features: first-order statistics, Minkowski functionals (MFs), and three-dimensional gray-level co-occurrence matrices (GLCMs). These features were applied in a machine learning environment for classification of TTE, using support vector machines. Results: In a clinical data set, containing 61 patients presenting obvious non-TTE and 38 patients presenting obvious TTE, we determined that patient-and treatment-related characteristics do not show any correlation to TTE. Furthermore, first-order statistical MRI features and MFs did not significantly show prognostic values using support vector machine classification. However, utilizing a set of 4 GLCM features, we achieved a sensitivity of 0.82 and a specificity of 0.69, showing their prognostic value of TTE. Moreover, these results increased for larger tumor volumes obtaining a sensitivity of 0.77 and a specificity of 0.89 for tumors larger than 6 cm 3 . Conclusions: The results found in this research clearly show that MRI tumor texture provides information that can be employed for predicting TTE. This can form a basis for individual VS treatment selection, further improving overall treatment results. Particularly in patients with large VSs, where the phenomenon of TTE is most relevant and our predictive model performs best, these findings can be implemented in a clinical workflow such that for each patient, the most optimal treatment strategy can be determined.

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Tumor-Volume Changes after Radiosurgery for Vestibular Schwannoma: Implications for Follow-Up MR Imaging Protocol

Cited by 77 publications

References 30 publications

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

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

Postoperative imaging of vestibular schwannomas

Prediction of transient tumor enlargement using MRI tumor texture after radiosurgery on vestibular schwannoma

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