RT Journal Article
SR Electronic
T1 Evaluation of Vestibular Schwannoma Size across Time: How Well Do the Experts Perform and What Can be Improved?
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A8614
A1 Bathla, Girish
A1 Mehta, Parv M.
A1 Soni, Neetu
A1 Johnson, Mathew
A1 Benson, John C.
A1 Messina, Steven A.
A1 Farnsworth, Paul
A1 Agarwal, Amit
A1 Carlson, Matthew L.
A1 Lane, John I.
YR 2025
UL http://www.ajnr.org/content/early/2025/05/08/ajnr.A8614.abstract
AB BACKGROUND AND PURPOSE: 2D linear measurements are often used in routine clinical practice during vestibular schwannoma (VS) follow-up, primarily due to wider availability and ease of use. We sought to determine the radiologist’s performance compared with 3D-volumetry, along with the impact of the number of linear measurements, slice thickness, and tumor volumes on these parameters.MATERIALS AND METHODS: Specificity and accuracy estimates and 95% confidence intervals were calculated for the entire cohort and subgroups on the basis of volumes (<400, 400–800, >800 mm3), slice thickness (≤1.5 mm or >1.5 mm), and number of linear dimensions measured in the radiology report (0–1 or 2–3).RESULTS: There was weak agreement between the radiologist’s inference and VS volumetry (0.45; 95% CI. 0.41–00.53). Agreement was lower when 0–1 tumor dimension was measured (0.29; 95% CI, 0.21–0.42), for smaller tumors of <400 mm3 (0.37; 95% CI, 0.28–0.45), and for thick-section imaging of >1.5 mm (0.36; 95% CI, 0.25–0.46). The reader sensitivity was modest (0.49–0.54), while the accuracy for detecting ≤ ±25% interval change was weak (0.32–0.38). Reader performance trended toward improvement with thin-section imaging, measurement of 2–3 VS dimensions, and larger tumors.CONCLUSIONS: In routine practice, radiologists show poor agreement with volumetric results and sensitivity to detect interval change and overall poor accuracy for volumetric changes of ≤ ± 25% in volume. In the absence of volumetric measurements, radiologists need to be more diligent when evaluating interval changes in VS.VSvestibular schwannoma