Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI
AuthorsLewis, Daniel; email: email@example.com
McHugh, Damien J.
Lloyd, Simon K.
Pathmanaban, Omar N.
King, Andrew T.
Coope, David J.
MetadataShow full item record
AbstractAbstract: 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.
CitationScientific Reports, volume 11, issue 1, page 15712
PublisherNature Publishing Group UK
DescriptionFrom Springer Nature via Jisc Publications Router
History: received 2021-03-01, accepted 2021-07-05, registration 2021-07-21, pub-electronic 2021-08-03, online 2021-08-03, collection 2021-12
Publication status: Published
Funder: CRUK and EPSRC Cancer Imaging Centre in Cambridge and Manchester; doi: http://dx.doi.org/10.13039/501100014679; Grant(s): C8742/A18097, C8742/A18097, C8742/A18097, C8742/A18097, C8742/A18097
Funder: Manchester Academic Health Sciences centre (MAHSC)