Association Between Pseudoprogression of Vestibular Schwannoma After Radiosurgery and Radiological Features of Solid and Cystic Components.

Autor:	Huang CY; Department of Radiology, Taipei Veterans General Hospital, Taipei , Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan., Peng SJ; Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei , Taiwan., Yang HC; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan.; Brain Research Center, National Yang Ming Chiao Tung University, Taipei , Taiwan.; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei , Taiwan., Wu HM; Department of Radiology, Taipei Veterans General Hospital, Taipei , Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan., Chen CJ; Department of Neurosurgery, The University of Texas Health Science Center, Houston , Texas , USA., Wang MC; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan.; Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei , Taiwan., Hu YS; Department of Radiology, Taipei Veterans General Hospital, Taipei , Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan., Lin CJ; Department of Radiology, Taipei Veterans General Hospital, Taipei , Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan., Shiau CY; Cancer Center, Taipei Veterans General Hospital, Taipei , Taiwan., Guo WY; Department of Radiology, Taipei Veterans General Hospital, Taipei , Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan., Chung WY; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan.; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei , Taiwan.; Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei , Taiwan., Pan DH; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei , Taiwan.; Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, Taipei , Taiwan., Lee CC; School of Medicine, National Yang Ming Chiao Tung University, Taipei , Taiwan.; Brain Research Center, National Yang Ming Chiao Tung University, Taipei , Taiwan.; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei , Taiwan.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2023 Dec 01; Vol. 93 (6), pp. 1383-1392. Date of Electronic Publication: 2023 Jul 11.
DOI:	10.1227/neu.0000000000002599
Abstrakt:	Background and Objectives: The pathophysiology of vestibular schwannoma (VS) pseudoprogression after Gamma Knife radiosurgery (GKRS) remains unclear. Radiological features in pretreatment magnetic resonance images may help predict VS pseudoprogression. This study used VS radiological features quantified using an automated segmentation algorithm to predict pseudoprogression after GKRS treatment. Methods: This is a retrospective study comprising 330 patients with VS who received GKRS. After image preprocessing and T2W/contrast-enhanced T1-weighted image (CET1W) image generation, with fuzzy C-means clustering, VSs were segmented into solid and cystic components and classified as solid and cystic. Relevant radiological features were then extracted. The response to GKRS was classified into "nonpseudoprogression" and "pseudoprogression/fluctuation". The Z test for two proportions was used to compare solid and cystic VS for the likelihood of pseudoprogression/fluctuation. Logistic regression was used to assess the correlation between clinical variables and radiological features and response to GKRS. Results: The likelihood of pseudoprogression/fluctuation after GKRS was significantly higher for solid VS compared with cystic VS (55% vs 31%, P < .001). For the entire VS cohort, multivariable logistic regression revealed that a lower mean tumor signal intensity (SI) in T2W/CET1W images was associated with pseudoprogression/fluctuation after GKRS ( P = .001). For the solid VS subgroup, a lower mean tumor SI in T2W/CET1W images ( P = .035) was associated with pseudoprogression/fluctuation after GKRS. For the cystic VS subgroup, a lower mean SI of the cystic component in T2W/CET1W images ( P = .040) was associated with pseudoprogression/fluctuation after GKRS. Conclusion: Pseudoprogression is more likely to occur in solid VS compared with cystic VS. Quantitative radiological features in pretreatment magnetic resonance images were associated with pseudoprogression after GKRS. In T2W/CET1W images, solid VS with a lower mean tumor SI and cystic VS with a lower mean SI of cystic component were more likely to have pseudoprogression after GKRS. These radiological features can help predict the likelihood of pseudoprogression after GKRS. (Copyright © Congress of Neurological Surgeons 2023. All rights reserved.)
Databáze:	MEDLINE
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