Pretreatment ADC predicts tumor control after Gamma Knife radiosurgery in solid vestibular schwannomas
| Autor: | Christopher Karakasis, Tamia Potter, Jonathan Lee, Varun R. Kshettry, Pranay Soni, Pablo F. Recinos, Hamid Borghei-Razavi, Matthew Poturalski |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry medicine.medical_treatment Acoustic neuroma Interventional radiology medicine.disease Radiosurgery 030218 nuclear medicine & medical imaging body regions 03 medical and health sciences 0302 clinical medicine Tumor progression medicine Effective diffusion coefficient Surgery Neurology (clinical) Neurosurgery Nuclear medicine business Pseudoprogression 030217 neurology & neurosurgery Neuroradiology |
| Zdroj: | Acta Neurochirurgica. 163:1013-1019 |
| ISSN: | 0942-0940 0001-6268 |
| DOI: | 10.1007/s00701-021-04738-x |
| Popis: | Radiosurgery is a well-established treatment for vestibular schwannomas (VSs), but it is often difficult to identify which tumors will respond to treatment. We sought to determine whether pretreatment or posttreatment tumor apparent diffusion coefficient (ADC) values could predict tumor control in patients undergoing Gamma Knife radiosurgery (GKRS) and whether these values could differentiate between cases of pseudoprogression and cases of true progression in the early posttreatment period. We retrospectively identified patients who underwent GKRS for solid VSs between June 2008 and November 2016 and who had a minimum follow-up of 36 months. Pretreatment and posttreatment minimum, mean, and maximum ADC values were measured for the whole tumor volume and were compared between patients with tumor control and those with tumor progression. In patients with early posttreatment tumor enlargement, ADC values were compared between patients with pseudoprogression and those with true progression. Of the 44 study patients, 34 (77.3%) demonstrated tumor control at final follow-up. Patients with tumor control had higher pretreatment minimum (1.35 vs 1.09; p = 0.008), mean (1.80 vs 1.45; p = 0.004), and maximum (2.41 vs 1.91; p = 0.011) ADC values than patients with tumor progression. ADC values did not differ between patients with pseudoprogression and those with true progression at early posttreatment follow-up. ADC values may be helpful in predicting response to GKRS in patients with solid VSs but cannot predict which tumors will undergo pseudoprogression. Patients with higher pretreatment ADC values may be more likely to demonstrate posttreatment tumor control. |
| Databáze: | OpenAIRE |
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