Volumetric growth rates of untreated vestibular schwannomas

Journal of Neurosurgery
Zane SchnurmanDouglas Kondziolka

Abstract

There remains a large discrepancy among surgeons in expectations of vestibular schwannoma (VS) growth. The anticipated growth rate of a VS and its potential clinical impact are important factors when deciding whether to observe the lesion over time or to intervene. Previous studies of VS natural growth remain limited, mostly confined to linear measurements, often without high-resolution, thin-sequence imaging. The present study comprehensively assessed natural tumor growth rates using volumetric measurements. Between 2012 and 2018, 212 treatment-naïve patients diagnosed with a unilateral VS were evaluated. A total of 699 MR images were assessed, with a range of 2-11 MR images per patient. All MR images preceded any intervention, with patients subsequently being observed through completion of data analysis (36%) or treated with stereotactic radiosurgery (32%) or microsurgical resection (32%). To determine precise tumor volumes, the tumor area was outlined on every slice, and the products of the area and slice thickness were summed (99% of scans were ≤ 1-mm slice thickness). A multilevel model with random effects was used to assess the mean volume change over time. Each tumor was categorized as one of the following: growing (volu...Continue Reading

Citations

Jul 8, 2020·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Sophia TranJacob B Hunter
Jan 11, 2020·Acta Neurologica Scandinavica·Sebastian DzierzęckiMirosław Ząbek
Mar 15, 2020·Neurosurgical Review·Elizabeth J BussMichael B Sisti
Oct 27, 2020·The Laryngoscope·Evan J PatelJohn T Roland

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