Diameter-Based Volumetric Models May Inadequately Calculate Jugular Paraganglioma Volume Following Sub-Total Resection.

Autor:	Totten DJ; Vanderbilt University School of Medicine., Sherry AD; Vanderbilt University School of Medicine., Manzoor NF; Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center., Perkins EL; Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center., Cass ND; Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center., Khattab MH; Department of Radiation Oncology, Vanderbilt University Medical Center., Cmelak AJ; Department of Radiation Oncology, Vanderbilt University Medical Center., Haynes DS; Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center., Aulino JM; Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee.
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2021 Oct 01; Vol. 42 (9), pp. e1339-e1345.
DOI:	10.1097/MAO.0000000000003226
Abstrakt:	Background: As gross total resection of jugular paragangliomas (JPs) may result in cranial nerve deficits, JPs are increasingly managed with subtotal resection (STR) with postoperative radiological monitoring. However, the validity of commonly used diameter-based models that calculate postoperative volume to determine residual tumor growth is dubious. The purpose of this study was to assess the accuracy of these models compared to manual volumetric slice-by-slice segmentation. Methods: A senior neuroradiologist measured volumes via slice-by-slice segmentation of JPs pre- and postoperatively from patients who underwent STR from 2007 to 2019. Volumes from three linear-based models were calculated. Models with absolute percent error (APE) > 20% were considered unsatisfactory based on a common volumetric definition for residual growth. Bland-Altman plots were used to evaluate reproducibility, and Wilcoxon matched-pairs signed rank test evaluated model bias. Results: Twenty-one patients were included. Median postoperative APE exceeded the established 20% threshold for each of the volumetric models as cuboidal, ellipsoidal, and spherical model APE were 63%, 28%, and 27%, respectively. The postoperative cuboidal model had significant systematic bias overestimating volume (p = 0.002) whereas the postoperative ellipsoidal and spherical models lacked systematic bias (p = 0.11 and p = 0.82). Conclusion: Cuboidal, ellipsoidal, and spherical models do not provide accurate assessments of postoperative JP tumor volume and may result in salvage therapies that are unnecessary or inappropriately withheld due to inaccurate assessment of residual tumor growth. While more time-consuming, slice-by-slice segmentation by an experienced neuroradiologist provides a substantially more accurate and precise measurement of tumor volume that may optimize clinical management. Competing Interests: David Haynes, Consultant for Med-El, Advanced Bionics, Stryker, and Cochlear. Other authors disclose no conflict of interest. (Copyright © 2021, Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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