Predictability of transient tumor enlargement following gamma knife radiosurgery on vestibular schwannoma

P.P.J.H. Langenhuizen, S.H.P. Sebregts, Sveta Zinger, Sieger Leenstra, P. Hanssens, Peter de With, H.B. Verheul

Research output: Contribution to conferenceAbstractAcademic

Abstract

IntroductionGamma Knife radiosurgery (GKRS) is a well-established treatment for small- to medium-sized vestibular schwannomas (VS). However, this treatment is controversial for larger VS. One of its drawbacks is that VS can present a radiation-induced transient tumor enlargement (TTE). For larger VS, such a swelling may cause symptoms related to mass effect, necessitating microsurgery. Currently, it is not possible to predict this adverse effect. We evaluated the predictability of TTE by quantitatively analyzing the tumor appearance on MRI. The goal is to determine the optimal treatment strategy, i.e. radiosurgery or microsurgery, on an individual basis. MethodsFrom our database, patients with large VS (>4cc) and minimum follow-up of three years, were identified. The TTE classification was based on evaluation of MRI scans at 6, 12, 24 and 36 months, according to strict volumetric criteria. We evaluated the influence of MRI tumor texture characteristics on TTE. These texture characteristics were quantified by calculating features based on gray-level co-occurrence matrices (GLCM), computed on T1-weighted, T2-weighted, and T1-weighted contrast-enhanced MRIs. Correlation was determined between these characteristics and TTE using machine-learning methods. ResultsBetween 2002 and 2015, 795 VS patients received GKRS as primary treatment at our center. The strict criteria for TTE and non-TTE led to the inclusion of 67 patients, of which 26 exhibited TTE. By employing GLCM-based features, we developed a model to predict TTE. We obtained a prediction sensitivity and specificity of 83% and 79%, respectively, using Support Vector Machines. These results improved for larger tumor volumes, i.e. in 7cc or larger, the results obtained were 85% and 87%, respectively. ConclusionResults from this research clearly show that MRI differences in VS tumor texture can be exploited to predict TTE in large VS. The developed prediction model can lead to an optimal treatment strategy selection on an individual basis.
Original languageEnglish
Publication statusPublished - Jun 2019
Event14th International Stereotactic Radiosurgery Society Congress - Windsor Expo Convention Center (WECC), Rio de Janeiro, Brazil
Duration: 9 Jun 201913 Jun 2019
https://2019.isrscongress.org/en/

Conference

Conference14th International Stereotactic Radiosurgery Society Congress
Abbreviated titleISRS2019
CountryBrazil
CityRio de Janeiro
Period9/06/1913/06/19
Internet address

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Acoustic Neuroma
Radiosurgery
Neoplasms
Microsurgery
Therapeutics
Tumor Burden

Keywords

  • transient tumor enlargement
  • vestibular schwannoma
  • gamma knife radiosurgery

Cite this

Langenhuizen, P. P. J. H., Sebregts, S. H. P., Zinger, S., Leenstra, S., Hanssens, P., de With, P., & Verheul, H. B. (2019). Predictability of transient tumor enlargement following gamma knife radiosurgery on vestibular schwannoma. Abstract from 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil.
Langenhuizen, P.P.J.H. ; Sebregts, S.H.P. ; Zinger, Sveta ; Leenstra, Sieger ; Hanssens, P. ; de With, Peter ; Verheul, H.B. / Predictability of transient tumor enlargement following gamma knife radiosurgery on vestibular schwannoma. Abstract from 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil.
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abstract = "IntroductionGamma Knife radiosurgery (GKRS) is a well-established treatment for small- to medium-sized vestibular schwannomas (VS). However, this treatment is controversial for larger VS. One of its drawbacks is that VS can present a radiation-induced transient tumor enlargement (TTE). For larger VS, such a swelling may cause symptoms related to mass effect, necessitating microsurgery. Currently, it is not possible to predict this adverse effect. We evaluated the predictability of TTE by quantitatively analyzing the tumor appearance on MRI. The goal is to determine the optimal treatment strategy, i.e. radiosurgery or microsurgery, on an individual basis. MethodsFrom our database, patients with large VS (>4cc) and minimum follow-up of three years, were identified. The TTE classification was based on evaluation of MRI scans at 6, 12, 24 and 36 months, according to strict volumetric criteria. We evaluated the influence of MRI tumor texture characteristics on TTE. These texture characteristics were quantified by calculating features based on gray-level co-occurrence matrices (GLCM), computed on T1-weighted, T2-weighted, and T1-weighted contrast-enhanced MRIs. Correlation was determined between these characteristics and TTE using machine-learning methods. ResultsBetween 2002 and 2015, 795 VS patients received GKRS as primary treatment at our center. The strict criteria for TTE and non-TTE led to the inclusion of 67 patients, of which 26 exhibited TTE. By employing GLCM-based features, we developed a model to predict TTE. We obtained a prediction sensitivity and specificity of 83{\%} and 79{\%}, respectively, using Support Vector Machines. These results improved for larger tumor volumes, i.e. in 7cc or larger, the results obtained were 85{\%} and 87{\%}, respectively. ConclusionResults from this research clearly show that MRI differences in VS tumor texture can be exploited to predict TTE in large VS. The developed prediction model can lead to an optimal treatment strategy selection on an individual basis.",
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author = "P.P.J.H. Langenhuizen and S.H.P. Sebregts and Sveta Zinger and Sieger Leenstra and P. Hanssens and {de With}, Peter and H.B. Verheul",
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Langenhuizen, PPJH, Sebregts, SHP, Zinger, S, Leenstra, S, Hanssens, P, de With, P & Verheul, HB 2019, 'Predictability of transient tumor enlargement following gamma knife radiosurgery on vestibular schwannoma' 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil, 9/06/19 - 13/06/19, .

Predictability of transient tumor enlargement following gamma knife radiosurgery on vestibular schwannoma. / Langenhuizen, P.P.J.H.; Sebregts, S.H.P.; Zinger, Sveta; Leenstra, Sieger; Hanssens, P.; de With, Peter; Verheul, H.B.

2019. Abstract from 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil.

Research output: Contribution to conferenceAbstractAcademic

TY - CONF

T1 - Predictability of transient tumor enlargement following gamma knife radiosurgery on vestibular schwannoma

AU - Langenhuizen, P.P.J.H.

AU - Sebregts, S.H.P.

AU - Zinger, Sveta

AU - Leenstra, Sieger

AU - Hanssens, P.

AU - de With, Peter

AU - Verheul, H.B.

PY - 2019/6

Y1 - 2019/6

N2 - IntroductionGamma Knife radiosurgery (GKRS) is a well-established treatment for small- to medium-sized vestibular schwannomas (VS). However, this treatment is controversial for larger VS. One of its drawbacks is that VS can present a radiation-induced transient tumor enlargement (TTE). For larger VS, such a swelling may cause symptoms related to mass effect, necessitating microsurgery. Currently, it is not possible to predict this adverse effect. We evaluated the predictability of TTE by quantitatively analyzing the tumor appearance on MRI. The goal is to determine the optimal treatment strategy, i.e. radiosurgery or microsurgery, on an individual basis. MethodsFrom our database, patients with large VS (>4cc) and minimum follow-up of three years, were identified. The TTE classification was based on evaluation of MRI scans at 6, 12, 24 and 36 months, according to strict volumetric criteria. We evaluated the influence of MRI tumor texture characteristics on TTE. These texture characteristics were quantified by calculating features based on gray-level co-occurrence matrices (GLCM), computed on T1-weighted, T2-weighted, and T1-weighted contrast-enhanced MRIs. Correlation was determined between these characteristics and TTE using machine-learning methods. ResultsBetween 2002 and 2015, 795 VS patients received GKRS as primary treatment at our center. The strict criteria for TTE and non-TTE led to the inclusion of 67 patients, of which 26 exhibited TTE. By employing GLCM-based features, we developed a model to predict TTE. We obtained a prediction sensitivity and specificity of 83% and 79%, respectively, using Support Vector Machines. These results improved for larger tumor volumes, i.e. in 7cc or larger, the results obtained were 85% and 87%, respectively. ConclusionResults from this research clearly show that MRI differences in VS tumor texture can be exploited to predict TTE in large VS. The developed prediction model can lead to an optimal treatment strategy selection on an individual basis.

AB - IntroductionGamma Knife radiosurgery (GKRS) is a well-established treatment for small- to medium-sized vestibular schwannomas (VS). However, this treatment is controversial for larger VS. One of its drawbacks is that VS can present a radiation-induced transient tumor enlargement (TTE). For larger VS, such a swelling may cause symptoms related to mass effect, necessitating microsurgery. Currently, it is not possible to predict this adverse effect. We evaluated the predictability of TTE by quantitatively analyzing the tumor appearance on MRI. The goal is to determine the optimal treatment strategy, i.e. radiosurgery or microsurgery, on an individual basis. MethodsFrom our database, patients with large VS (>4cc) and minimum follow-up of three years, were identified. The TTE classification was based on evaluation of MRI scans at 6, 12, 24 and 36 months, according to strict volumetric criteria. We evaluated the influence of MRI tumor texture characteristics on TTE. These texture characteristics were quantified by calculating features based on gray-level co-occurrence matrices (GLCM), computed on T1-weighted, T2-weighted, and T1-weighted contrast-enhanced MRIs. Correlation was determined between these characteristics and TTE using machine-learning methods. ResultsBetween 2002 and 2015, 795 VS patients received GKRS as primary treatment at our center. The strict criteria for TTE and non-TTE led to the inclusion of 67 patients, of which 26 exhibited TTE. By employing GLCM-based features, we developed a model to predict TTE. We obtained a prediction sensitivity and specificity of 83% and 79%, respectively, using Support Vector Machines. These results improved for larger tumor volumes, i.e. in 7cc or larger, the results obtained were 85% and 87%, respectively. ConclusionResults from this research clearly show that MRI differences in VS tumor texture can be exploited to predict TTE in large VS. The developed prediction model can lead to an optimal treatment strategy selection on an individual basis.

KW - transient tumor enlargement

KW - vestibular schwannoma

KW - gamma knife radiosurgery

M3 - Abstract

ER -

Langenhuizen PPJH, Sebregts SHP, Zinger S, Leenstra S, Hanssens P, de With P et al. Predictability of transient tumor enlargement following gamma knife radiosurgery on vestibular schwannoma. 2019. Abstract from 14th International Stereotactic Radiosurgery Society Congress, Rio de Janeiro, Brazil.