Measuring Vestibular Schwannoma Signal Intensity on Enhanced MRI May Help Predict Growth

What is the relationship between signal intensity on gadolinium (Gd)-enhanced magnetic resonance images (MRIs) and growth of vestibular schwannomas (VSs)?

BOTTOM LINE

Growing VSs show higher signal intensities on Gd-enhanced MRIs and, therefore, measuring signal intensity of VS on Gd-enhanced MRI may aid in predicting VS growth.

BACKGROUND: VS incidence has recently risen, likely due to increased application of MRI, particularly Gd-enhanced MRI, resulting in identification of more subclinical cases. Blood flow and inflammation are thought to be correlated with signal intensity on Gd-enhanced MRI. Growing VSs may show high signal intensity on these imaging studies.

STUDY DESIGN: Cross-sectional study.

SETTING: Department of Otorhinolaryngology, Head and Neck Surgery, Ehime University School of Medicine, Toon, Japan.

SYNOPSIS: After identifying 225 patients with VS who underwent MRI between January 2010 and January 2016, researchers pinpointed 31 adult patients (21 female, average age 62.90 years) who met the criteria of having had sporadic VS and had received an MRI at least once via a 3T whole-body system. Signal intensity, as well as tumor volume, location, and property, were evaluated. Fifteen patients (48.39%) had a growing tumor. Researchers’ findings showed that the signal intensities of Gd-enhanced MRI of growing VS were significantly greater than those of nongrowing VS. Of the 31 tumors imaged at presentation, 22 and nine were solid and cystic, respectively, and median volume on the last MR image was 620 mm³. Ten patients exhibited a purely intrameatal VS, while 21 had an extrameatal VS. The proportion of extrameatal tumors in growing VSs was significantly higher than that in nongrowing VSs, suggesting that measuring signal intensity on Gd-enhanced MRI may become essential for predicting VS growth. Study limitations included its limited sample size, retrospective design, and limited mean imaging interval.

CITATION: Yamada H, Kai N, Hiratsuka Y, et al. Comparison of the signal intensity of vestibular schwannoma between growing and nongrowing tumors. Laryngoscope. 2022;132:198-203.