Response prediction of vestibular schwannoma after gamma-knife radiosurgery using pretreatment dynamic contrast-enhanced MRI: a prospective study.

Autor: Hwang I; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Choi SH; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. verocay@snuh.org.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea. verocay@snuh.org.; Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. verocay@snuh.org.; Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul, 08826, Republic of Korea. verocay@snuh.org., Kim JW; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Republic of Korea., Yeon EK; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Lee JY; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Yoo RE; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.; Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea., Kang KM; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Yun TJ; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Kim JH; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea., Sohn CH; Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.; Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.; Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2022 Jun; Vol. 32 (6), pp. 3734-3743. Date of Electronic Publication: 2022 Jan 27.
DOI: 10.1007/s00330-021-08517-1
Abstrakt: Objectives: There are few known predictive factors for response to gamma-knife radiosurgery (GKRS) in vestibular schwannoma (VS). We investigated the predictive role of pretreatment dynamic contrast-enhanced (DCE)-MRI parameters regarding the tumor response after GKRS in sporadic VS.
Methods: This single-center prospective study enrolled participants between April 2017 and February 2019. We performed a volumetric measurement of DCE-MRI-derived parameters before GKRS. The tumor volume was measured in a follow-up MRI. The pharmacokinetic parameters were compared between responders and nonresponders according to 20% or more tumor volume reduction. Stepwise multivariable logistic regression analyses were performed, and the diagnostic performance of DCE-MRI parameters for the prediction of tumor response was evaluated by receiver operating characteristic curve analysis.
Results: Ultimately, 35 participants (21 women, 52 ± 12 years) were included. There were 22 (62.9%) responders with a mean follow-up interval of 30.2 ± 5.7 months. K trans (0.036 min -1 vs. 0.057 min -1 , p = .008) and initial area under the time-concentration curve within 90 s (IAUC90) (84.4 vs. 143.6, p = .003) showed significant differences between responders and nonresponders. K trans (OR = 0.96, p = .021) and IAUC90 (OR = 0.97, p = .004) were significant differentiating variables in each multivariable model with clinical variables for tumor response prediction. K trans showed a sensitivity of 81.8% and a specificity of 69.2%, and IAUC90 showed a sensitivity of 100% and a specificity of 53.8% for tumor response prediction.
Conclusion: DCE-MRI (particularly K trans and IAUC90) has the potential to be a predictive factor for tumor response in VS after GKRS.
Key Points: •Pretreatment prediction of gamma-knife radiosurgery response in vestibular schwannoma is still challenging. •Dynamic contrast-enhanced MRI could have predictive value for the response of vestibular schwannoma after gamma-knife radiosurgery.
(© 2022. The Author(s), under exclusive licence to European Society of Radiology.)
Databáze: MEDLINE
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