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10.09.2018 | Original Article

Radiosurgery of vestibular schwannoma: prognostic factors for hearing outcome using 3D-constructive interference in steady state (3D-CISS)

verfasst von: Franca Wagner, MD, Matteo Gandalini, Arsany Hakim, MD, Ekin Ermis, MD, Dominic Leiser, MD, Martin Zbinden, Lukas Anschuetz, MD, Andreas Raabe, MD, Marco Caversaccio, MD, Roland Wiest, MD, Evelyn Herrmann, MD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 12/2018

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Abstract

Purpose

Stereotactic radiosurgery (SRS) is an effective treatment for vestibular schwannoma (VS). Three-dimensional (3D) constructive interference in steady state (CISS) is the preferred magnetic resonance imaging (MRI) sequence for evaluating signal changes in the inner ear endolymph. Previous studies demonstrated a correlation between pretreatment cochlear signal intensity in 3D-CISS and posttherapeutic hearing outcomes. The purpose of our study was to compare 3D-CISS sequences before and after primary SRS of unilateral VSs to evaluate the effect of radiosurgery on the 3D-CISS signal intensities of cochlea and sacculus/utriculus.

Methods

We retrospectively reviewed 47 patients with unilateral VS treated with SRS. The neuroradiological MRI datasets were analysed to evaluate the signal intensity of the inner ear structure, tumour size, Koos grade, tumour volume, and infiltration of the cochlear aperture before therapy and at follow-up. The differences in these signal intensities before SRS and at follow-up were correlated with clinical symptoms, cochlear radiation dose, tumour volume and infiltration of the cochlear aperture.

Results

No differences were found between signal intensities in cochlea and utriculus/sacculus before and after SRS and no correlation with clinical symptoms, cochlear radiation dose, tumour volume, Koos grade or infiltration of the cochlear aperture (all p > 0.05).

Conclusion

Our study supports the theory of a complex interaction causing alteration of the endolymph protein concentration and not a direct dependency on the SRS. Use of modern dosing schemes will have a positive impact on clinical outcome with preservation of hearing in patients with VS.

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Titel: Radiosurgery of vestibular schwannoma: prognostic factors for hearing outcome using 3D-constructive interference in steady state (3D-CISS)
verfasst von: Franca Wagner, MD
Matteo Gandalini
Arsany Hakim, MD
Ekin Ermis, MD
Dominic Leiser, MD
Martin Zbinden
Lukas Anschuetz, MD
Andreas Raabe, MD
Marco Caversaccio, MD
Roland Wiest, MD
Evelyn Herrmann, MD
Publikationsdatum: 10.09.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 12/2018
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1361-8

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Radiosurgery of vestibular schwannoma: prognostic factors for hearing outcome using 3D-constructive interference in steady state (3D-CISS)