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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

The Effectiveness of Diffusion Tensor Imaging in Determining Radiological Response after Radiosurgery in Patients with Vestibular Schwannoma

Author(s): Dilek Hacer Cesme*, Alpay Alkan, Lutfullah Sari, Ahmet Kaya, Ismail Yurtsever, Gokberk Alkan, Mehmet Hakan Seyithanoglu and Mustafa Aziz Hatiboglu

Volume 17, Issue 5, 2021

Published on: 27 January, 2021

Page: [602 - 607] Pages: 6

DOI: 10.2174/1573405617666210127160848

Abstract

Background: The effectiveness of Diffusion Tensor Imaging (DTI) in demonstrating functional changes in the tumor in determining the response to treatment after radiosurgery in patients with vestibular schwannoma (VS) is not clear yet.

Objective: The study aimed to determine the change in total tumor volume (TTV) in terms of radiological response in patients who had VS and were treated with radiosurgery and investigated the relationship between the TTV, follow-up times and DTI parameters.

Methods: Thirty-one patients were assessed using DTI and MRI. TTV, apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were calculated. Patients were divided into three groups: those who responded to the treatment (group 1) (n=11), those who did not (group 0) (n=9) and those who remained stable (group 2) (n=11).

Results: The mean duration of follow-up was 28.81±14 months. ADC values increased in patients with VS after radiosurgery (p=0.004). There was no statistical difference in the FA values. A significant reduction in TTV after radiosurgery was detected in group 1 (p=0.003). ADC values increased significantly after radiosurgery in group 2 (p=0.04). Although there were no significant differences, ADC values after radiosurgery increased in group 1 and group 0.

Conclusions: ADC values continuously increase due to radiation damage in the period before the tumor volume shrinks after radiosurgery. We think that it is not appropriate to diagnose inadequate treatment or progression only when TTV is evaluated in terms of response to treatment in the early period after radiosurgery.

Keywords: Radiosurgery, gamma knife radiosurgery, vestibular schwannomas, tumor volume, diffusion tensor imaging, apparent diffusion coefficient.

Graphical Abstract

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