Dynamic contrast-enhanced and diffusion-weighted MR imaging for predicting tumor growth of sporadic vestibular schwannomas: a prospective study

S M Schouten Sammy; Daniel Lewis; S Cornelissen Stefan; K Li Ka-Loh; X Zhu Xiaoping; M C Maas Marnix; S Pegge Sjoert; T T G Jansen Thijs; J J S Mulder Jef; J J Waterval Jérôme; A A Postma Alida; O Pathmanaban Omar; D J Coope David; J M M Derks Jolanda; P P J H Langenhuizen Patrick; A T King Andrew; J B Verheul Jeroen; H P M Kunst Dirk

doi:10.1093/neuonc/noae252

Dynamic contrast-enhanced and diffusion-weighted MR imaging for predicting tumor growth of sporadic vestibular schwannomas: a prospective study

S M Schouten Sammy, Daniel Lewis, S Cornelissen Stefan, K Li Ka-Loh, X Zhu Xiaoping, M C Maas Marnix, S Pegge Sjoert, T T G Jansen Thijs, J J S Mulder Jef, J J Waterval Jérôme, A A Postma Alida, O Pathmanaban Omar, D J Coope David, J M M Derks Jolanda, P P J H Langenhuizen Patrick, A T King Andrew, J B Verheul Jeroen, H P M Kunst Dirk

Division of Cancer Sciences (L5)

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Advanced MR imaging, such as diffusion-weighted (DWI) and dynamic contrast-enhanced (DCE) imaging, may provide valuable non-invasive information on intrinsic tumor biology. This study aims to evaluate apparent diffusion coefficient (ADC) and DCE-MRI-derived microvascular parameter values (Ktrans, ve, and vp) as potential imaging predictors for future sporadic vestibular schwannoma (VS) growth.

METHODS: In this prospective cohort study, patients with newly diagnosed unilateral sporadic VS and an initial wait-and-scan strategy were enrolled between January 2021 and January 2023. Patients underwent a single timepoint comprehensive MRI protocol, including DWI and DCE-MRI sequences. The estimated values of ADC, Ktrans, ve, and vp were calculated using established pipelines on a voxelwise basis within the delineated tumor region of interest. Associations of the estimated parameter values with volumetric growth were evaluated in uni- and multivariable logistic regression and survival analyses.

RESULTS: Of the 110 analyzed patients, 70 (64%) exhibited growth during follow-up. A significant correlation was primarily observed between the DCE-MRI-derived parameters and VS growth. The combination of mean Ktrans (P<0.001) and ve (P<0.001) tumor values provided an internally validated model with an AUC of 0.85 for growth, yielding a sensitivity of 89% and specificity of 73% at the optimized cutoff value. Only the mean ADC values were found to be significantly higher in shrinking tumors (P=0.04).

CONCLUSIONS: The strongly significant correlation observed between VS growth and Ktrans and ve tumor values indicates great potential of the non-invasive DCE-MRI for individualized VS management in clinical practice. External validation is needed to further substantiate these findings.

Original language	English
Journal	Neuro-Oncology
DOIs	https://doi.org/10.1093/neuonc/noae252
Publication status	E-pub ahead of print - 23 Nov 2024

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10.1093/neuonc/noae252

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Schouten Sammy, S. M., Lewis, D., Cornelissen Stefan, S., Li Ka-Loh, K., Zhu Xiaoping, X., Maas Marnix, M. C., Pegge Sjoert, S., Jansen Thijs, T. T. G., Mulder Jef, J. J. S., Waterval Jérôme, J. J., Postma Alida, A. A., Pathmanaban Omar, O., Coope David, D. J., Derks Jolanda, J. M. M., Langenhuizen Patrick, P. P. J. H., King Andrew, A. T., Verheul Jeroen, J. B., & Kunst Dirk, H. P. M. (2024). Dynamic contrast-enhanced and diffusion-weighted MR imaging for predicting tumor growth of sporadic vestibular schwannomas: a prospective study. Neuro-Oncology. Advance online publication. https://doi.org/10.1093/neuonc/noae252

@article{884b86cdaf9f49ccb698ffbf4eaedbef,

title = "Dynamic contrast-enhanced and diffusion-weighted MR imaging for predicting tumor growth of sporadic vestibular schwannomas: a prospective study",

abstract = "BACKGROUND: Advanced MR imaging, such as diffusion-weighted (DWI) and dynamic contrast-enhanced (DCE) imaging, may provide valuable non-invasive information on intrinsic tumor biology. This study aims to evaluate apparent diffusion coefficient (ADC) and DCE-MRI-derived microvascular parameter values (Ktrans, ve, and vp) as potential imaging predictors for future sporadic vestibular schwannoma (VS) growth.METHODS: In this prospective cohort study, patients with newly diagnosed unilateral sporadic VS and an initial wait-and-scan strategy were enrolled between January 2021 and January 2023. Patients underwent a single timepoint comprehensive MRI protocol, including DWI and DCE-MRI sequences. The estimated values of ADC, Ktrans, ve, and vp were calculated using established pipelines on a voxelwise basis within the delineated tumor region of interest. Associations of the estimated parameter values with volumetric growth were evaluated in uni- and multivariable logistic regression and survival analyses.RESULTS: Of the 110 analyzed patients, 70 (64%) exhibited growth during follow-up. A significant correlation was primarily observed between the DCE-MRI-derived parameters and VS growth. The combination of mean Ktrans (P<0.001) and ve (P<0.001) tumor values provided an internally validated model with an AUC of 0.85 for growth, yielding a sensitivity of 89% and specificity of 73% at the optimized cutoff value. Only the mean ADC values were found to be significantly higher in shrinking tumors (P=0.04).CONCLUSIONS: The strongly significant correlation observed between VS growth and Ktrans and ve tumor values indicates great potential of the non-invasive DCE-MRI for individualized VS management in clinical practice. External validation is needed to further substantiate these findings.",

author = "{Schouten Sammy}, {S M} and Daniel Lewis and {Cornelissen Stefan}, S and {Li Ka-Loh}, K and {Zhu Xiaoping}, X and {Maas Marnix}, {M C} and {Pegge Sjoert}, S and {Jansen Thijs}, {T T G} and {Mulder Jef}, {J J S} and {Waterval J{\'e}r{\^o}me}, {J J} and {Postma Alida}, {A A} and {Pathmanaban Omar}, O and {Coope David}, {D J} and {Derks Jolanda}, {J M M} and {Langenhuizen Patrick}, {P P J H} and {King Andrew}, {A T} and {Verheul Jeroen}, {J B} and {Kunst Dirk}, {H P M}",

note = "{\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].",

year = "2024",

month = nov,

day = "23",

doi = "10.1093/neuonc/noae252",

language = "English",

journal = "Neuro-Oncology",

issn = "1522-8517",

publisher = "Oxford University Press",

}

Schouten Sammy, SM, Lewis, D, Cornelissen Stefan, S, Li Ka-Loh, K, Zhu Xiaoping, X, Maas Marnix, MC, Pegge Sjoert, S, Jansen Thijs, TTG, Mulder Jef, JJS, Waterval Jérôme, JJ, Postma Alida, AA, Pathmanaban Omar, O, Coope David, DJ, Derks Jolanda, JMM, Langenhuizen Patrick, PPJH, King Andrew, AT, Verheul Jeroen, JB & Kunst Dirk, HPM 2024, 'Dynamic contrast-enhanced and diffusion-weighted MR imaging for predicting tumor growth of sporadic vestibular schwannomas: a prospective study', Neuro-Oncology. https://doi.org/10.1093/neuonc/noae252

TY - JOUR

T1 - Dynamic contrast-enhanced and diffusion-weighted MR imaging for predicting tumor growth of sporadic vestibular schwannomas

T2 - a prospective study

AU - Schouten Sammy, S M

AU - Lewis, Daniel

AU - Cornelissen Stefan, S

AU - Li Ka-Loh, K

AU - Zhu Xiaoping, X

AU - Maas Marnix, M C

AU - Pegge Sjoert, S

AU - Jansen Thijs, T T G

AU - Mulder Jef, J J S

AU - Waterval Jérôme, J J

AU - Postma Alida, A A

AU - Pathmanaban Omar, O

AU - Coope David, D J

AU - Derks Jolanda, J M M

AU - Langenhuizen Patrick, P P J H

AU - King Andrew, A T

AU - Verheul Jeroen, J B

AU - Kunst Dirk, H P M

N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

PY - 2024/11/23

Y1 - 2024/11/23

N2 - BACKGROUND: Advanced MR imaging, such as diffusion-weighted (DWI) and dynamic contrast-enhanced (DCE) imaging, may provide valuable non-invasive information on intrinsic tumor biology. This study aims to evaluate apparent diffusion coefficient (ADC) and DCE-MRI-derived microvascular parameter values (Ktrans, ve, and vp) as potential imaging predictors for future sporadic vestibular schwannoma (VS) growth.METHODS: In this prospective cohort study, patients with newly diagnosed unilateral sporadic VS and an initial wait-and-scan strategy were enrolled between January 2021 and January 2023. Patients underwent a single timepoint comprehensive MRI protocol, including DWI and DCE-MRI sequences. The estimated values of ADC, Ktrans, ve, and vp were calculated using established pipelines on a voxelwise basis within the delineated tumor region of interest. Associations of the estimated parameter values with volumetric growth were evaluated in uni- and multivariable logistic regression and survival analyses.RESULTS: Of the 110 analyzed patients, 70 (64%) exhibited growth during follow-up. A significant correlation was primarily observed between the DCE-MRI-derived parameters and VS growth. The combination of mean Ktrans (P<0.001) and ve (P<0.001) tumor values provided an internally validated model with an AUC of 0.85 for growth, yielding a sensitivity of 89% and specificity of 73% at the optimized cutoff value. Only the mean ADC values were found to be significantly higher in shrinking tumors (P=0.04).CONCLUSIONS: The strongly significant correlation observed between VS growth and Ktrans and ve tumor values indicates great potential of the non-invasive DCE-MRI for individualized VS management in clinical practice. External validation is needed to further substantiate these findings.

AB - BACKGROUND: Advanced MR imaging, such as diffusion-weighted (DWI) and dynamic contrast-enhanced (DCE) imaging, may provide valuable non-invasive information on intrinsic tumor biology. This study aims to evaluate apparent diffusion coefficient (ADC) and DCE-MRI-derived microvascular parameter values (Ktrans, ve, and vp) as potential imaging predictors for future sporadic vestibular schwannoma (VS) growth.METHODS: In this prospective cohort study, patients with newly diagnosed unilateral sporadic VS and an initial wait-and-scan strategy were enrolled between January 2021 and January 2023. Patients underwent a single timepoint comprehensive MRI protocol, including DWI and DCE-MRI sequences. The estimated values of ADC, Ktrans, ve, and vp were calculated using established pipelines on a voxelwise basis within the delineated tumor region of interest. Associations of the estimated parameter values with volumetric growth were evaluated in uni- and multivariable logistic regression and survival analyses.RESULTS: Of the 110 analyzed patients, 70 (64%) exhibited growth during follow-up. A significant correlation was primarily observed between the DCE-MRI-derived parameters and VS growth. The combination of mean Ktrans (P<0.001) and ve (P<0.001) tumor values provided an internally validated model with an AUC of 0.85 for growth, yielding a sensitivity of 89% and specificity of 73% at the optimized cutoff value. Only the mean ADC values were found to be significantly higher in shrinking tumors (P=0.04).CONCLUSIONS: The strongly significant correlation observed between VS growth and Ktrans and ve tumor values indicates great potential of the non-invasive DCE-MRI for individualized VS management in clinical practice. External validation is needed to further substantiate these findings.

U2 - 10.1093/neuonc/noae252

DO - 10.1093/neuonc/noae252

M3 - Article

C2 - 39579371

SN - 1522-8517

JO - Neuro-Oncology

JF - Neuro-Oncology

ER -

Dynamic contrast-enhanced and diffusion-weighted MR imaging for predicting tumor growth of sporadic vestibular schwannomas: a prospective study

Abstract

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