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Research ArticleHead and Neck Imaging

Correlation between Cranial Nerve Microstructural Characteristics and Vestibular Schwannoma Tumor Volume

A.M. Halawani, S. Tohyama, P.S.-P. Hung, B. Behan, M. Bernstein, S. Kalia, G. Zadeh, M. Cusimano, M. Schwartz, F. Gentili, D.J. Mikulis, N.J. Laperriere and M. Hodaie
American Journal of Neuroradiology October 2021, 42 (10) 1853-1858; DOI: https://doi.org/10.3174/ajnr.A7257
A.M. Halawani
aFrom the Division of Brain Imaging, and Behaviour–Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
eDepartment of Medical Imaging (A.M.H., D.J.M.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
fDivision of Neuroradiology (A.M.H., D.J.M.), Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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  • ORCID record for A.M. Halawani
S. Tohyama
aFrom the Division of Brain Imaging, and Behaviour–Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
bInstitute of Medical Science, (S.T., P.S.-P.H., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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P.S.-P. Hung
aFrom the Division of Brain Imaging, and Behaviour–Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
bInstitute of Medical Science, (S.T., P.S.-P.H., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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B. Behan
gOntario Brain Institute (B.B.), Toronto, Ontario, Canada
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M. Bernstein
cDepartment of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
dDivision of Neurosurgery (M.B., S.K., F.G., M.H.), Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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S. Kalia
cDepartment of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
dDivision of Neurosurgery (M.B., S.K., F.G., M.H.), Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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G. Zadeh
cDepartment of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
jThe Arthur and Sonia Labatt Brain Tumor Research Centre (G.Z.), Hospital for Sick Children, Toronto, Ontario, Canada
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M. Cusimano
cDepartment of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
hDivision of Neurosurgery (M.C.), Saint Michael's Hospital, Toronto, Ontario, Canada
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M. Schwartz
iDivision of Neurosurgery (M.S.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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F. Gentili
cDepartment of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
dDivision of Neurosurgery (M.B., S.K., F.G., M.H.), Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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D.J. Mikulis
aFrom the Division of Brain Imaging, and Behaviour–Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
eDepartment of Medical Imaging (A.M.H., D.J.M.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
fDivision of Neuroradiology (A.M.H., D.J.M.), Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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N.J. Laperriere
kDepartment of Radiation Oncology (N.J.L.), University of Toronto, Toronto, Ontario, Canada
lDivision of Radiation Oncology (N.J.L.), Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
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M. Hodaie
aFrom the Division of Brain Imaging, and Behaviour–Systems Neuroscience (A.M.H., S.T., P.S.-P.H., D.J.M., M.H.), Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
bInstitute of Medical Science, (S.T., P.S.-P.H., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
cDepartment of Surgery (M.B., S.K., G.Z., M.C., F.G., M.H.), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
dDivision of Neurosurgery (M.B., S.K., F.G., M.H.), Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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  • FIG 1.
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    FIG 1.

    T1-weighted anatomic image (A) and 2 fused DTI/T1-weighted images (B and C) with superimposed representation of tumor volume (green) used to locate the ROIs within the distal cisternal/IC segments (A) and to demonstrate the extracted CN VII/VIII tracts (B and C). Note the detailed correspondence of the tumor and its effect on CN VII/VIII (white arrows). The CN VII/VIII can be seen sweeping anterior to the tumor. Also, note scattered, disconnected fibers that are not corresponding to CN configuration in space. These fibers were disregarded anatomically (arrowheads).

  • FIG 2.
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    FIG 2.

    Microstructural properties of the CN VII/VIII in patients with VS. The averaged mean value of the diffusivity measurements in all patients with VS that demonstrate abnormal WM microstructural changes in their VII/VIII nerves (four asterisks indicate P < .0001 false discovery rate–corrected). DTI-derived values ± standard error of the mean of affected (black bars) and unaffected (gray bars) sides. Compared with the unaffected side, patients had significantly higher FA (A) and lower AD (B), RD (C), and MD (D) on their affected side. Diffusion is in square millimeters/second.

  • FIG 3.
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    FIG 3.

    Scatterplots of the relationship between tumor volume and microstructural properties in the affected CNs VII/VIII. A weak-but-significant inverse relationship exists between the tumor volume and the specific diffusivities: axial diffusivity (B), radial diffusivity (C), and mean diffusivity (D), but not with FA (A) (significant at P < .01; false discovery rate–corrected). Diffusion is in square millimeters/second.

Tables

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  • The mean, median, and range values for averaged FA and diffusivity

    MeanMedianRange
    FA (mm2/s)
        Affected0.3570.3320.108–0.722
        Nonaffected0.2870.2560.114–0.746
    AD (mm2/s)
        Affected0.0020.0020.001–0.006
        Nonaffected0.0030.0030.001–0.005
    RD (mm2/s)
        Affected0.0010.0010–0.004
        Nonaffected0.0020.0020–0.003
    MD (mm2/s)
        Affected0.0010.0010–0.005
        Nonaffected0.0020.0020–0.004
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American Journal of Neuroradiology: 42 (10)
American Journal of Neuroradiology
Vol. 42, Issue 10
1 Oct 2021
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Cite this article
A.M. Halawani, S. Tohyama, P.S.-P. Hung, B. Behan, M. Bernstein, S. Kalia, G. Zadeh, M. Cusimano, M. Schwartz, F. Gentili, D.J. Mikulis, N.J. Laperriere, M. Hodaie
Correlation between Cranial Nerve Microstructural Characteristics and Vestibular Schwannoma Tumor Volume
American Journal of Neuroradiology Oct 2021, 42 (10) 1853-1858; DOI: 10.3174/ajnr.A7257

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Correlation between Cranial Nerve Microstructural Characteristics and Vestibular Schwannoma Tumor Volume
A.M. Halawani, S. Tohyama, P.S.-P. Hung, B. Behan, M. Bernstein, S. Kalia, G. Zadeh, M. Cusimano, M. Schwartz, F. Gentili, D.J. Mikulis, N.J. Laperriere, M. Hodaie
American Journal of Neuroradiology Oct 2021, 42 (10) 1853-1858; DOI: 10.3174/ajnr.A7257
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