Yıl: 2021 Cilt: 36 Sayı: 1 Sayfa Aralığı: 7 - 13 Metin Dili: İngilizce DOI: 10.5222/MMJ.2021.15564 İndeks Tarihi: 05-06-2021

Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma

Öz:
Objective: To investigate changes in DTI (Diffusion Tensor Imaging) parameters in brainstem subcortical auditory pathways after Gamma Knife Radiosurgery (GKR) in patients with intracanalicular vestibular schwannoma (ICVS) and to analyze the relationship between tumor volume and ADC (apparent diffusion coefficient) and FA (fractional anisotropy) values.Method: Seventeen patients with ICVS were evaluated before and after GKR. ADC and FA values of the lateral lemniscus (LL) and inferior colliculus (IC) and tumor volume were calculated. Patients who responded to GKR were classified as Group 1 and those who did not respond adequately as Group 2. The relationship between ADC and FA values and changes in tumor volume were analyzed.Results: Tumor volume significantly decreased after GKR. ADC values obtained from the tumor increased after GKR (p:0.002). There was no significant difference in LL and IC before and after GKR in terms of FA and ADC values (n:17). There was a positive correlation between response to treatment and contralateral LL ADC values after GKR (p=0.005, r:0.652). There was a negative correlation between contralateral IC FA values after GKR and response to treatment (p=0.017, r: -0.568). There was a significant difference between Groups 1 and 2 in regards to contralateral LL ADC (p=0.03) and IC FA values (p=0.017).Conclusion: Since the cochlear nerve and subcortical auditory pathways have low regeneration potential after nerve damage, ADC and FA changes in LL and IC may be explained with the presence of intracanalicular tumors prior to GKR. Since GKR does not cause additional damage to the subcortical auditory pathways at the brainstem level, we think that GKR is a noninvasive treatment method that can be used safely in patients with ICVS.
Anahtar Kelime:

İntrakanaliküler Vestibüler Şıvannomada Gamma Knife Radyocerrahisi Sonrası Beyin Sapı Subkortikal İşitme Yollarının Difüzyon Tensör Görüntüleme ile Değerlendirilmesi

Öz:
Amaç: İntrakanaliküler vestibüler schwannomlu (ICVS) olgularda Gamma Knife Radyocerrahisi (GKR) sonrası beyin sapı subkortikal işitsel yollarda DTG (Difüzyon Tensör Görüntüleme) parametrelerinde değişiklik olup olmadığını araştırmak ve tümör hacmi ile ADC (görünür difüzyon katsayısı) ve FA (görünür difüzyon katsayısı) değerleri arasındaki ilişkiyi analiz etmek Yöntem: ICVS’li 17 hasta radyocerrahi öncesi ve sonrası değerlendirildi. Lateral lemniscus (LL) ve inferior kollikulus (IC) ADC ve FA değerleri ve tümör hacmi hesaplandı. Radyocerrahi tedavisine yanıt verenler Grup 1, yeterli yanıt vermeyenler ise Grup 2 olarak sınıflandırıldı. ADC ve FA değerleri ile tümor hacim değişiklikleri arasındaki ilişki analiz edildi. Bulgular: Radyocerrahi sonrası tümör hacmi belirgin azalmıştı. GKR sonrası tümörden elde edilen ADC değerleri arttı (p:0,002). GKR öncesi ve sonrası LL ve IC’de FA ve ADC değerleri (n:17) açısından anlamlı farklılık saptanmadı. Tedaviye yanıt ile GKR sonrası kontralateral LL ADC değerleri arasında pozitif korelasyon mevcuttu (p=0,005, r:0,652). GKR sonrası kontralateral IC FA değerleri ile tedaviye yanıt arasında negatif korelasyon saptandı (p=0,017, r:-0,568). Grup 1 ile Grup 2 arasında kontralateral LL ADC (p=0,03) ve IC FA değerleri (p=0,017) açısından anlamlı fark vardı. Sonuç: Kohlear sinir ve subkortikal işitme yolakların düşük rejenerasyon potansiyeli sahip olması nedeniyle LL ve IC’deki ADC ve FA değişiklikleri mevcut olan intrakanaliküler tümör varlığı ile açıklanabilir. Radyocerrahi, beyin sapı düzeyinde subkortikal işitme yollarına ek hasar vermediğinden dolayı GKR’nin ICVS’li hastalarda güvenle kullanılabilecek noninvaziv bir tedavi yöntemi olduğunu düşünüyoruz.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Massager N, Nissim O, Delbrouck C, et al. Role of ıntracanalicular volumetric and dosimetric parameters on hearing preservation after vestibular schwannoma radiosurgery. Int J Radiat Oncol Biol Phys. 2006;64:1331-40. [CrossRef]
  • 2. Dzierzęcki S, Turek G, Czapsk B, et al. Gamma knife surgery in the treatment of intracanalicular vestibular schwannomas. Acta Neurol Scand. 2020;141:415-22. [CrossRef]
  • 3. Udawatta M, Kwan I, Preet K, et al. Hearing preservation for vestibular schwannomas treated with stereotactic radiosurgery or fractionated stereotactic radiotherapy. World Neurosurg. 2019;129:e303-10. [CrossRef]
  • 4. Buss EJ, Wang TJC, Sisti MB. Stereotactic radiosurgery for management of vestibular schwannoma: a short review. Neurosurg Rev. 2020. [CrossRef]
  • 5. Wu YW, Karandikar A, Goh JPN, Tan TY. Imaging features differentiating vestibular ganglion from intracanalicular schwannoma on single-sequence non-contrast magnetic resonance ımaging study. Ann Acad Med Singapore. 2020;49:65-71. [CrossRef]
  • 6. Niranjan A, Mathieu D, Kondziolka D, Flickinger JC, Lunsford LD. Radiosurgery for intracanalicular vestibular schwannomas. Prog Neurol Surg. 2008;21:192-9. [CrossRef]
  • 7. Rueb D, Pöhlmann L, Grau S, et al. Long-term follow-up after stereotactic radiosurgery of intracanalicular acoustic neurinoma. Radiat Oncol. 2017;12:68. [CrossRef]
  • 8. Kirchmann M, Karnov K, Hansen S, Dethloff T, Stangerup SE, Caye-Thomasen P. Ten-year follow-up on tumor growth and hearing in patients observed with an intracanalicular vestibular schwannoma. Neurosurgery. 2017;80:49-56. [CrossRef]
  • 9. Kurtcan S, Alkan A, Kilicarslan R, et al. Auditory pathway features determined by DTI in subjects with unilateral acoustic neuroma. Clin Neuroradiol. 2016;26:439-44. [CrossRef]
  • 10. Rueckriegel SM, Homola GA, Hummel M, Willner N, Ernestus RI, Matthies C. Probabilistic fiber-tracking reveals degeneration of the contralateral auditory pathway in patients with vestibular schwannoma. AJNR Am J Neuroradiol. 2016;37:1610-6. [CrossRef]
  • 11. Wu CM, Ng SH, Liu TC. Diffusion tensor imaging of the subcortical auditory tract in subjects with long-term unilateral sensorineural hearing loss. Audiol Neurootol. 2009;14:248-53. [CrossRef]
  • 12. Camargo A, Schneider T, Liu L, Pakpoor J, Kleinberg L, Yousem DM. Pretreatment ADC values predict response to radiosurgery in vestibular schwannomas. AJNR Am J Neuroradiol. 2017;38:1200-5. [CrossRef]
  • 13. Plotkin SR, Halpin C, Blakeley JO, et al. Suggested response criteria for phase II antitumor drug studies for neurofibromatosis type 2 related vestibular schwannoma. J Neurooncol. 2009;93:61-77. [CrossRef]
  • 14. van de Langenberg R, Dohmen AJC, de Bondt BJ, Nelemans PJ, Baumert BG, Stokroos RJ. Volume changes after stereotactic LINAC radiotherapy in vestibular schwannoma: control rate and growth patterns. Int J Radiat Oncol Biol Phys. 2012;84:343-9. [CrossRef]
  • 15. Lin YC, Wang CC, Wai YY, et al. Significant temporal evolution of diffusion anisotropy for evaluating early response to radiosurgery in patients with vestibular schwannoma: findings from functional diffusion maps. AJNR Am J Neuroradiol. 2010;31:269-74. [CrossRef]
  • 16. Stangerup SE, Caye-Thomasen P, Tos M, Thomsen J. The natural history of vestibular schwannoma. Otol Neurotol. 2006;27:547-52. [CrossRef]
  • 17. Han JH, Kim DG, Chung HT, Paek SH, Jung HW. Hearing outcomes after stereotactic radiosurgery for vestibular schwannomas: mechanism of hearing loss and how to preserve hearing. Adv Tech Stand Neurosurg. 2016;43:3-36. [CrossRef]
  • 18. Meydan S, Aydin S, Otcu H, Kitis S, Alkan A. Assessment of auditory pathways using diffusion tensor imaging in patients with neurofibromatosis type 1. Curr Med Imaging Rev. 2019;15:890-4. [CrossRef]
  • 19. Bernal B, Altman NR. Auditory functional MR imaging. AJR Am J Roentgenol. 2001;176:1009-15. [CrossRef]
  • 20. Wu CM, Ng SH, Wang JJ, Liu TC. Diffusion tensor imaging of the subcortical auditory tract in subjects with congenital cochlear nerve deficiency. AJNR Am J Neuroradiol. 2009;30:1773-7. [CrossRef]
  • 21. Kim S, Kwon HJ, Kang EJ, Kim DW. Diffusion-tensor tractography of the auditory neural pathway. Clin Neuroradiol. 2020;30:115-22. [CrossRef]
  • 22. Kim YH, Kim DG, Han JG, et al. Hearing outcomes after stereotactic radiosurgery for unilateral intracanalicular vestibular schwannomas: implication of transient volume expansion. Int J Radiation Oncol Biol Phys. 2013;85:61-7. [CrossRef] Available from: https://www.sciencedirect.com/science/article/abs/pii/S0360301612004336
APA Cesme D, ALKAN A, Gültekin M, Sari L, ALKAN G, SEYİTHANOĞLU H, Hatiboglu M (2021). Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. , 7 - 13. 10.5222/MMJ.2021.15564
Chicago Cesme Dilek Hacer,ALKAN ALPAY,Gültekin Mehmet Ali,Sari Lutfullah,ALKAN GOKBERK,SEYİTHANOĞLU HAKAN,Hatiboglu Mustafa Aziz Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. (2021): 7 - 13. 10.5222/MMJ.2021.15564
MLA Cesme Dilek Hacer,ALKAN ALPAY,Gültekin Mehmet Ali,Sari Lutfullah,ALKAN GOKBERK,SEYİTHANOĞLU HAKAN,Hatiboglu Mustafa Aziz Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. , 2021, ss.7 - 13. 10.5222/MMJ.2021.15564
AMA Cesme D,ALKAN A,Gültekin M,Sari L,ALKAN G,SEYİTHANOĞLU H,Hatiboglu M Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. . 2021; 7 - 13. 10.5222/MMJ.2021.15564
Vancouver Cesme D,ALKAN A,Gültekin M,Sari L,ALKAN G,SEYİTHANOĞLU H,Hatiboglu M Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. . 2021; 7 - 13. 10.5222/MMJ.2021.15564
IEEE Cesme D,ALKAN A,Gültekin M,Sari L,ALKAN G,SEYİTHANOĞLU H,Hatiboglu M "Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma." , ss.7 - 13, 2021. 10.5222/MMJ.2021.15564
ISNAD Cesme, Dilek Hacer vd. "Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma". (2021), 7-13. https://doi.org/10.5222/MMJ.2021.15564
APA Cesme D, ALKAN A, Gültekin M, Sari L, ALKAN G, SEYİTHANOĞLU H, Hatiboglu M (2021). Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. Medeniyet Medical Journal, 36(1), 7 - 13. 10.5222/MMJ.2021.15564
Chicago Cesme Dilek Hacer,ALKAN ALPAY,Gültekin Mehmet Ali,Sari Lutfullah,ALKAN GOKBERK,SEYİTHANOĞLU HAKAN,Hatiboglu Mustafa Aziz Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. Medeniyet Medical Journal 36, no.1 (2021): 7 - 13. 10.5222/MMJ.2021.15564
MLA Cesme Dilek Hacer,ALKAN ALPAY,Gültekin Mehmet Ali,Sari Lutfullah,ALKAN GOKBERK,SEYİTHANOĞLU HAKAN,Hatiboglu Mustafa Aziz Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. Medeniyet Medical Journal, vol.36, no.1, 2021, ss.7 - 13. 10.5222/MMJ.2021.15564
AMA Cesme D,ALKAN A,Gültekin M,Sari L,ALKAN G,SEYİTHANOĞLU H,Hatiboglu M Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. Medeniyet Medical Journal. 2021; 36(1): 7 - 13. 10.5222/MMJ.2021.15564
Vancouver Cesme D,ALKAN A,Gültekin M,Sari L,ALKAN G,SEYİTHANOĞLU H,Hatiboglu M Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma. Medeniyet Medical Journal. 2021; 36(1): 7 - 13. 10.5222/MMJ.2021.15564
IEEE Cesme D,ALKAN A,Gültekin M,Sari L,ALKAN G,SEYİTHANOĞLU H,Hatiboglu M "Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma." Medeniyet Medical Journal, 36, ss.7 - 13, 2021. 10.5222/MMJ.2021.15564
ISNAD Cesme, Dilek Hacer vd. "Evaluation of Brainstem Subcortical Auditory Pathways with Diffusion Tensor Imaging After Gamma Knife Radiosurgery in Intracanalicular Vestibular Schwannoma". Medeniyet Medical Journal 36/1 (2021), 7-13. https://doi.org/10.5222/MMJ.2021.15564