Journal article
Loss of Enhancement in Vestibular Schwannomas Post Stereotactic Radiosurgery: Impact on Tumor Control and Serviceable Hearing
Otology & neurotology, Vol.47(2), pp.e432-e438
02/2026
DOI: 10.1097/MAO.0000000000004728
PMID: 41199442
Abstract
Vestibular schwannomas (VSs) treated with stereotactic radiosurgery (SRS) often show transient loss of central tumor enhancement. We hypothesized that this loss of enhancement may correlate with better tumor control on follow-up imaging.
We evaluated 198 consecutive patients from a single center who met eligibility criteria. Tumor volumes on the pre-SRS and post-SRS scans were quantified along with regions of loss of enhancement on the first post-SRS study. The latter was correlated with tumor volumes at follow-up, radiation isocenter density, and loss of serviceable hearing.
For the entire cohort, the median loss of enhancement on the first post-SRS scan was 14% (IQR: 6 to 25) and median rate of change in tumor volume was -4.5% per year (IQR: -10.5 to 1.5). Percent loss of central enhancement showed significant negative correlation with tumor growth not only for the entire cohort (correlation coefficient: -0.18, P=0.01), but also for the subset of patients who had available imaging until at least 2 years (n=185) and 4 years (n=179) post-SRS. Loss of enhancement also strongly correlated positively with tumor volumes and number of radiation isocenters and negatively with isocenter density. Finally, patients with greater percent loss of enhancement had an increased likelihood of progression to non-serviceable hearing, although this association was not statistically significant.
These findings suggest that loss of central tumor enhancement in VSs post-SRS may be associated with improved tumor control.
Details
- Title: Subtitle
- Loss of Enhancement in Vestibular Schwannomas Post Stereotactic Radiosurgery: Impact on Tumor Control and Serviceable Hearing
- Creators
- Prav Mehta - Mayo ClinicNeetu Soni - Mayo Clinic in FloridaJohn C Benson - Mayo Clinic in ArizonaRamin Morshed - Mayo Clinic in ArizonaChristine M Lohse - Mayo Clinic in FloridaAmit Agarwal - Mayo Clinic in FloridaMilan Sonka - University of IowaMichael J Link - Mayo Clinic in FloridaJohn P Marinelli - Mayo Clinic in ArizonaEric E Babajanian - Mayo Clinic in ArizonaGhazal Daher - Mayo Clinic in ArizonaJim R Dornhoffer - Mayo Clinic in ArizonaKarl R Khandalavala - Mayo Clinic in ArizonaMatthew L Carlson - Mayo Clinic in ArizonaPaul J Farnsworth - Mayo Clinic in ArizonaJohn I Lane - Mayo Clinic in ArizonaGirish Bathla - Mayo Clinic in Arizona
- Resource Type
- Journal article
- Publication Details
- Otology & neurotology, Vol.47(2), pp.e432-e438
- DOI
- 10.1097/MAO.0000000000004728
- PMID
- 41199442
- NLM abbreviation
- Otol Neurotol
- ISSN
- 1537-4505
- eISSN
- 1537-4505
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Language
- English
- Electronic publication date
- 11/07/2025
- Date published
- 02/2026
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Electrical and Computer Engineering; Radiation Oncology; Fraternal Order of Eagles Diabetes Research Center; Injury Prevention Research Center; Ophthalmology and Visual Sciences
- Record Identifier
- 9985024143602771
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