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The predictive value of preoperative apparent diffusion coefficient (ADC) for facial nerve outcomes after vestibular schwannoma resection: clinical study

  • Original Article - Brain Tumors
  • Published:
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Abstract

Object

Diffusion MRI has been used to predict intraoperative consistency of tumors. Apparent diffusion coefficient (ADC) has shown predictive value as an imaging biomarker in many CNS tumors but has not been studied in a large cohort of patients with vestibular schwannoma. In this study, we examine the utility of ADC as a predictive biomarker for intraoperative tumor characteristics and postoperative facial nerve outcome.

Methods

A retrospective review of patients who underwent vestibular schwannoma resection at our institution from 2008 to 2018 yielded 87 patients, of which 72 met inclusion criteria. Operative reports and clinical records were reviewed for clinical data; MRI data were interpreted in a blinded fashion for qualitative and quantitative biomarkers, including tumor ADC.

Results

Mean tumor ADC values did not predict intraoperative consistency or adherence (p = 0.63). Adherent tumors were associated with worse facial nerve outcomes (p = 0.003). Regression tree analysis identified 3 ADC categories with statistically different facial nerve outcomes. The categories identified were ADC < 1006.04 × 10−6 mm2/s; ADC 1006.04–1563.93 × 10−6 mm2/s and ADC ≥ 1563.94 × 10−6 mm2/s. Postoperative and final House-Brackmann (HB) scores were significantly higher in the intermediate ADC group (2.3, p = 0.0038). HB outcomes were similar between the group with ADC < 1006.04 × 10−6 mm2/s and ≥ 1563.94 × 10−6 mm2/s (1.3 vs 1.3).

Conclusions

Middle-range preoperative ADC in vestibular schwannoma suggests a less favorable postoperative HB score. Preoperative measurement of ADC in vestibular schwannoma may provide additional information regarding prognostication of facial nerve outcomes.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, 80045, USA

    Katherine E. Kunigelis, Gregory Arnone & A. Samy Youssef

  2. Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO, USA

    Patrick Hosokawa

  3. Department of Radiology, University of Colorado School of Medicine, Aurora, CO, 80045, USA

    David Raban, Adam Starr & Ashesh A. Thaker

  4. University of Colorado School of Medicine, Aurora, CO, 80045, USA

    Andrei Gurau, Alexis Sunshine & Jason Bunn

  5. Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, 80045, USA

    A. Samy Youssef

Authors
  1. Katherine E. Kunigelis
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  2. Patrick Hosokawa
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Correspondence to A. Samy Youssef.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (name of institute/committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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General disclosures

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1. Mizuho America: royalty.

2. Stryker: consultant.

Portions of this work were presented in as proceedings at EANS Meeting, in Dublin, AANS Master class on 9/28/2019.

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Kunigelis, K.E., Hosokawa, P., Arnone, G. et al. The predictive value of preoperative apparent diffusion coefficient (ADC) for facial nerve outcomes after vestibular schwannoma resection: clinical study. Acta Neurochir 162, 1995–2005 (2020). https://doi.org/10.1007/s00701-020-04338-1

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  • DOI: https://doi.org/10.1007/s00701-020-04338-1

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