Abstract
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 radiologist performance compared to 3D-volumetry, along with the impact of number of linear measurements, slice thickness and tumor volumes on these parameters. Single center retrospective study with 97 patients (592 MRI studies). Overall agreement, sensitivity, specificity and accuracy estimates and 95% confidence intervals were calculated for the entire cohort, and subgroups based on 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). There was weak agreement between radiologist inference and VS volumetry (0.45, 95% CI [0.41, 0.53]). Agreement was lower when 0-1 tumor dimension was measured (0.29, 95% CI [0.21, 0.42]), for smaller tumors < 400 mm3 (0.37, 95% CI [0.28, 0.45]), and for thick section imaging > 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 towards improvement with thin-section imaging, measurement of 2-3 VS dimensions and for larger tumors. In routine practice, radiologists show poor agreement with volumetric results and sensitivity to detect interval change and overall poor accuracy for volumetric changes ≤ ± 25% in volume. In the absence of volumetric measurements, radiologists need to be more diligent when evaluating for interval changes in VS.
Published Version
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