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Multidisciplinary neurofibromatosis conference in the management of patients with neurofibromatosis type 1 and schwannomatosis in a single tertiary care institution

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Skeletal Radiology Aims and scope Submit manuscript

Abstract  

Objective

To evaluate the role of weekly neurofibromatosis (NF) multi-disciplinary conferences (MDC) on the diagnostic and therapeutic plan for patients with NF type 1 (NF1) and schwannomatosis (SWN).

Materials and methods

This retrospective study reviewed patients with confirmed or suspected NF1 and SWN discussed in weekly MDC from March to July 2021. Demographic data collected included patient age, sex, pre-conference and post-conference diagnosis, radiological studies reviewed, and provider specialties in attendance. Outcomes reported included changes in imaging interpretation and treatment plans, changes in post-conference diagnosis relative to pre-conference diagnosis, and time to completion of the recommended change in treatment.

Results

Data from 17 MDC “pre-conference” lists included 75 patients (38 female, 37 males, mean age (years): 38 (range: 6–80)) with NF1 (52%, 39/75) and SWN (36%, 27/75) discussed over a total of 91 case reviews. 18.7% (14/75) of all patients had NF2-related SWN, and 17.3% (13/75) of all patients had non-NF2 SWN. The MDC led to changes in imaging interpretation in 18.7% and changes in patient management in 74.7% (diagnostic testing (n = 52), surgical plan (n = 24), medical treatment (n = 9), clinical trial status (n = 4), and radiation treatment (n = 1)) of cases. Among patients for whom a change in management was recorded, 91% (62/68) completed at least one recommendation (mean time to completion (days): 41.4 (range: 0–278)).

Conclusion

Weekly MDC changes the diagnostic and therapeutic management of the majority of patients discussed (74.7%) and promotes a high adherence rate to recommendations (91%).

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Authors and Affiliations

  1. The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, JHOC 3014, Baltimore, MD, 21287, USA

    Patrick Debs, Laura Fayad & Shivani Ahlawat

  2. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Allan Belzberg & Bronwyn Slobogean

  3. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Jaishri Blakeley, Shannon Langmead & Carlos Romo

  4. Division of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Laura Fayad

  5. Comprehensive Neurofibromatosis Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Emily Little

  6. McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Krista Schatz

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  1. Patrick Debs
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  2. Allan Belzberg
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  3. Jaishri Blakeley
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  10. Shivani Ahlawat
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Correspondence to Shivani Ahlawat.

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Debs, P., Belzberg, A., Blakeley, J. et al. Multidisciplinary neurofibromatosis conference in the management of patients with neurofibromatosis type 1 and schwannomatosis in a single tertiary care institution. Skeletal Radiol 53, 909–916 (2024). https://doi.org/10.1007/s00256-023-04511-4

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  • DOI: https://doi.org/10.1007/s00256-023-04511-4

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