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A Novel Imaging Grading Biomarker for Predicting Hearing Loss in Acoustic Neuromas

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Abstract

Purpose

The aim of this study was to investigate an imaging biomarker based on contrast enhanced T1-weighted and T2-weighted magnetic resonance imaging (MRI) to determine the hearing loss related to acoustic neuromas (AN).

Methods

In this retrospective study, 441 acoustic neuromas treated with microsurgery were included. The diagnostic and follow-up MRI and audiometry of these patients were compared.

Results

We discovered a new MRI grading biomarker based on the percentage of tumor filling the inner auditory canal (TFIAC classification). The area under the receiver operating characteristics (AUROC) curve was highest for TFIAC (0.675), followed by period of observation (0.615) and tumor size (0.6) (P < 0.001). The percentage of patients in TFIAC grade III (90.1%) experiencing hypoacusis prior to microsurgery was significantly higher than that in TFIAC grade I (72.7%, P = 0.037) and TFIAC grade IV patients had a higher rate of non-serviceable hearing compared to TFIAC grade III patients (P < 0.001). During the follow-up, TFIAC grade IV patients experienced a significantly higher rate of non-serviceable hearing than TFIAC grade III patients in all ANs (P < 0.001) and in serviceable hearing acoustic neuroma cases prior to surgery (TFIAC grade IV 55.4%, TFIAC grade III 69.0%, P = 0.045). The TFIAC grade IV patients experienced a significantly higher rate of facial nerve dysfunction than TFIAC grade III patients after surgery (grade IV 48.0%, grade III 26.1%, P < 0.001).

Conclusion

The TFIAC classification serves as a potential imaging biomarker for preoperative and postoperative hearing prediction in ANs, which may aid neurosurgeons in predicting hearing loss and selecting optimal surgical strategies.

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Abbreviations

AAO-HNS:

American Academy of Otolaryngology-Head and Neck Surgery

ABR:

Auditory brainstem response

AN:

Acoustic neuromas

AUROC:

Area under the receiver operating characteristics

GR:

Gardner-Robertson

H‑B:

House-Brackmann

IAC:

Inner auditory canal

MRI:

Magnetic resonance imaging

ROC:

Receiver operating characteristics

RT:

Radiation therapy

SDS:

Speech discrimination score

SRT:

Speech repetition threshold

TFIAC:

Tumor filling inner auditory canal

VS:

Vestibular schwannomas

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Funding

This work was financially supported by the Beijing Municipal Health Commission of China (Grant No. PXM2019_026280_000002, Recipient: Wang Jia).

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Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 West Road, South Fourth Ring Road, Beijing, China

    Wenjianlong Zhou, Yangyang Wang, Shunchang Ma, Linhao Yuan, Xi Wang, Jiayi Peng, Dainan Zhang, Xiudong Guan, Deling Li, Guijun Jia & Wang Jia

  2. Edwin L. Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Wenjianlong Zhou

  3. China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing, China

    Shunchang Ma & Wang Jia

  4. Beijing Neurosurgical Institute, Beijing, China

    Shunchang Ma & Wang Jia

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  1. Wenjianlong Zhou
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Contributions

W.Z., Y.W., W.J. designed and performed experiments; W.Z., Y.W., S.M., L.Y. analyzed data and wrote the paper; X.W., D.Z., J.P., X.G. collected data from the Ddatabase system of Beijing Tiantan Hospital; G.J., W.J. performed the surgery; D.L. and W.J. provided statistical analysis and critical revision.

Corresponding author

Correspondence to Wang Jia.

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Conflict of interest

W. Zhou, Y. Wang, S. Ma, L. Yuan, X. Wang, J. Peng,D. Zhang, X. Guan, D. Li, G. Jia and W. Jia declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of Beijing Tiantan Hospital Research Committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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The data and materials that support the findings of this study are available from the corresponding author on reasonable request.

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Zhou, W., Wang, Y., Ma, S. et al. A Novel Imaging Grading Biomarker for Predicting Hearing Loss in Acoustic Neuromas. Clin Neuroradiol 31, 599–610 (2021). https://doi.org/10.1007/s00062-020-00938-7

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  • DOI: https://doi.org/10.1007/s00062-020-00938-7

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