Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI

Abstract 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....

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Autores principales:	Daniel Lewis, Damien J. McHugh, Ka-loh Li, Xiaoping Zhu, Catherine Mcbain, Simon K. Lloyd, Alan Jackson, Omar N. Pathmanaban, Andrew T. King, David J. Coope
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/abc5338c782846e3994c05568021a4d2
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spelling	oai:doaj.org-article:abc5338c782846e3994c05568021a4d22021-12-02T18:49:16ZDetection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI10.1038/s41598-021-95022-62045-2322https://doaj.org/article/abc5338c782846e3994c05568021a4d22021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95022-6https://doaj.org/toc/2045-2322Abstract 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.Daniel LewisDamien J. McHughKa-loh LiXiaoping ZhuCatherine McbainSimon K. LloydAlan JacksonOmar N. PathmanabanAndrew T. KingDavid J. CoopeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Daniel Lewis Damien J. McHugh Ka-loh Li Xiaoping Zhu Catherine Mcbain Simon K. Lloyd Alan Jackson Omar N. Pathmanaban Andrew T. King David J. Coope Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI
description	Abstract 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.
format	article
author	Daniel Lewis Damien J. McHugh Ka-loh Li Xiaoping Zhu Catherine Mcbain Simon K. Lloyd Alan Jackson Omar N. Pathmanaban Andrew T. King David J. Coope
author_facet	Daniel Lewis Damien J. McHugh Ka-loh Li Xiaoping Zhu Catherine Mcbain Simon K. Lloyd Alan Jackson Omar N. Pathmanaban Andrew T. King David J. Coope
author_sort	Daniel Lewis
title	Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI
title_short	Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI
title_full	Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI
title_fullStr	Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI
title_full_unstemmed	Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI
title_sort	detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear mri
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/abc5338c782846e3994c05568021a4d2
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Detection of early changes in the post-radiosurgery vestibular schwannoma microenvironment using multinuclear MRI

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