What is the optimal postoperative magnetic resonance imaging (MRI) schedule and length of follow-up for patients undergoing microsurgical excision of vestibular schwannoma (VS)?
The current recommended MRI surveillance schedule after micro-surgery for VS includes MRIs at one, five, and 10 years postoperatively. Nonparametric survival analysis suggests that a majority of radiologic progression events occur in the first 10 years postoperatively.
Explore this issue:September 2017
Background: Postoperative imaging surveillance after microsurgery for VS is performed routinely by neurotologists to screen patients for growth of residual or recurrent tumor. Nodular enhancement on postoperative gadolinium-enhanced MRI within the confines of the preoperative tumor margin is a possible indication of tumor residua/recurrence, but it is not definitive. Thus, serial imaging in cases with nodular enhancement on MRI is essential to determine whether residual tumor is present and growing. However, recommendations for the timing and frequency of MRI for VS surveillance after treatment have not been standardized.
Study design: Retrospective review of 220 patients who underwent microsurgical excision of VS at a single tertiary care center between January 1993 and March 2004.