Dynamic contrast-enhanced magnetic resonance imaging for evaluating early response to radiosurgery in patients with vestibular schwannoma


ÖZER H., YAZOL M., Erdogan N., EMMEZ Ö. H., KURT G., ÖNER A. Y.

JAPANESE JOURNAL OF RADIOLOGY, vol.40, no.7, pp.678-688, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 40 Issue: 7
  • Publication Date: 2022
  • Doi Number: 10.1007/s11604-021-01245-y
  • Journal Name: JAPANESE JOURNAL OF RADIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Agricultural & Environmental Science Database, Biotechnology Research Abstracts, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.678-688
  • Keywords: Magnetic resonance imaging, Vestibular schwannoma, Radiosurgery, GAMMA-KNIFE RADIOSURGERY, MRI PREDICT RESPONSE, TUMOR-VOLUME CHANGES, BREAST-CANCER, PRIMARY CHEMOTHERAPY, RECTAL-CANCER, PERFUSION MRI, BIOMARKERS, SURVIVAL, CHEMORADIOTHERAPY
  • Gazi University Affiliated: Yes

Abstract

Purpose This study aimed to use dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to evaluate early treatment response in vestibular schwannoma (VS) patients after radiosurgery. Methods Twenty-four VS patients who underwent gamma knife radiosurgery were prospectively followed up for at least four years. DCE-MRI sequences, in addition to standard MRI protocol, were obtained prior to radiosurgery, at 3 and 6 months. Conventionally, treatment responses based on tumor volume changes were classified as regression or stable (RS), transient tumor enlargement (TTE), and continuous tumor enlargement (CTE). DCE-MRI parameters, such as K-trans, K-ep and V-e, were compared according to follow-up periods and between groups. The diagnostic performance was tested using receiver operating characteristic (ROC) curves. Results Changes in tumor volume were as follows at the last 48 months of follow-up: RS in 11 patients (45.8%), TTE in 10 patients (41.7%), and CTE in three patients (12.5%). The median time required to distinguish TTE from CTE using conventional MRI was 12 months (range 9-18). The K-trans and V-e were significantly decreased in patients with RS and TTE at 3 and 6 months, but did not differ significantly in patients with CTE. There were no significant differences in K-trans and V-e between patients with RS and TTE at 3 and 6 months. Both K-trans and V-e demonstrated high diagnostic performance in evaluating early treatment response to radiosurgery in patients with VS. Conclusion DCE-MRI may aid in the monitoring and early prediction of treatment response in patients with VS following radiosurgery.