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Arterial spin labeling imaging correlates with the angiographic and clinical vascularity of vestibular schwannomas

Abstract

Purpose

Hypervascular vestibular schwannomas (HVSs) are a type of the vestibular schwannomas (VSs) that are extremely difficult to remove. We examined whether HVSs can be predicted by using arterial spin labeling (ASL) imaging.

Methods

A total of 103 patients with VSs underwent ASL imaging and digital subtraction angiography (DSA) before surgery. Regional cerebral blood flow (CBF) of gray matter and regional tumor blood flow (TBF) were calculated from ASL imaging, and we defined the ratio of TBF to CBF as the relative TBF (rTBF = TBF/CBF). Angiographic vascularity was evaluated by DSA, and clinical vascularity was evaluated by the degree of intraoperative tumor bleeding. Based on the angiographic and clinical vascularity, the VSs were divided into two categories: HVS and non-HVS. We compared rTBF with angiographic and clinical vascularities, retrospectively.

Results

The mean rTBFs of angiographic non-HVSs and HVSs were 1.29 and 2.58, respectively (p < 0.0001). At a cutoff value of 1.55, the sensitivity and specificity were 93.9% and 72.9%, respectively. The mean rTBFs of clinical non-HVS and HVSs were 1.45 and 2.22, respectively (p = 0.0002). At a cutoff value of 1.55, the sensitivity and specificity were 79.4% and 66.7%, respectively.

Conclusion

The rTBF calculated from ASL imaging correlates well with tumor vascularity and may be useful for predicting HVSs before surgery.

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Acknowledgments

The authors would like to thank Enago (www.enago.jp) for the English language review.

Funding information

This study did not receiving any funding.

Author information

Correspondence to Yujiro Tanaka.

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The authors declare that they have no conflict of interest.

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The institutional review board of our hospital approved this retrospective study.

For this type of study, formal consent was not required.

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Informed consent was obtained from all individual participants included in the study.

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Tanaka, Y., Kohno, M., Hashimoto, T. et al. Arterial spin labeling imaging correlates with the angiographic and clinical vascularity of vestibular schwannomas. Neuroradiology (2020). https://doi.org/10.1007/s00234-019-02358-y

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Keywords

  • Hypervascular vestibular schwannoma
  • Arterial spin labeling
  • Tumor blood flow
  • Angioraphic vascularity
  • Clinical vascularity