Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI
Authors
Lewis, D.McHugh, Damien J
Li, K. L.
Zhu, X.
McBain, Catherine A
Lloyd, S. K.
Jackson, A.
Pathmanaban, O. N.
King, A. T
Coope, D. J.
Affiliation
Dept. of Neurosurgery, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Stott Lane, Salford, Greater Manchester, M6 8HDIssue Date
2021
Metadata
Show full item recordAbstract
Stereotactic radiosurgery (SRS) is an established, effective therapy against vestibular schwannoma (VS). The mechanisms of tumour response are, however, unknown and in this study we sought to evaluate changes in the irradiated VS tumour microenvironment through a multinuclear MRI approach. Five patients with growing sporadic VS underwent a multi-timepoint comprehensive MRI protocol, which included diffusion tensor imaging (DTI), dynamic contrast-enhanced (DCE) MRI and a spiral 23Na-MRI acquisition for total sodium concentration (TSC) quantification. Post-treatment voxelwise changes in TSC, DTI metrics and DCE-MRI derived microvascular biomarkers (Ktrans, ve and vp) were evaluated and compared against pre-treatment values. Changes in tumour TSC and microvascular parameters were observable as early as 2 weeks post-treatment, preceding changes in structural imaging. At 6 months post-treatment there were significant voxelwise increases in tumour TSC (p < 0.001) and mean diffusivity (p < 0.001, repeated-measures ANOVA) with marked decreases in tumour microvascular parameters (p < 0.001, repeated-measures ANOVA). This study presents the first in vivo evaluation of alterations in the VS tumour microenvironment following SRS, demonstrating that changes in tumour sodium homeostasis and microvascular parameters can be imaged as early as 2 weeks following treatment. Future studies should seek to investigate these clinically relevant MRI metrics as early biomarkers of SRS response.Citation
Lewis D, McHugh DJ, Li K, Zhu X, Mcbain C, Lloyd SK, et al. Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI. Sci Rep. 2021 Aug 3;11(1).Journal
Scientific ReportsDOI
10.1038/s41598-021-95022-6PubMed ID
34344960Additional Links
https://dx.doi.org/10.1038/s41598-021-95022-6Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1038/s41598-021-95022-6