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Non-contrast Magnetic Resonance Imaging for Diagnosis and Monitoring of Vestibular Schwannomas

A Systematic Review and Meta-analysis

Kim, Do Hyun*; Lee, Seoungmin*; Hwang, Se Hwan

doi: 10.1097/MAO.0000000000002416
REVIEW ARTICLE
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Objective: This study aimed to evaluate the diagnostic accuracy of high-resolution T2-weighted magnetic resonance imaging (T2wi) in terms of detecting vestibular schwannoma compared with gadolinium-enhanced T1-weighted MRI (GdT1wi).

Data Sources: Five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database).

Data Selection: Two authors independently searched five databases up to January 2019 on diagnosis of vestibular schwannomas via T2wi.

Data Extraction: In the included studies, tumor diameters reported using T2wi were compared with those revealed by GdT1wi and correlation coefficients were calculated. Data on true-positives, true-negatives, false-positives, and false-negatives were extracted from the relevant articles. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Inter-rater agreement among different observers and intra-rater agreement among different measurements made by a single observer was assessed.

Data Synthesis: Outcomes subjected to analysis included diagnostic accuracy (the diagnostic odds ratio); summary receiver operating characteristic curve and area under the curve values. The summary intra-class correlation coefficient was used for various random-effects models. The quality of each study was analyzed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool.

Conclusions: T2wi performed without the use of a contrast agent is a highly accurate diagnostic and monitor tool compared with GdT1wi and also demonstrated high reliability. However, further studies are required to confirm the results of this study.

*Department of Otolaryngology–Head and Neck Surgery, Seoul St. Mary's Hospital

Department of Otolaryngology–Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

Address correspondence and reprint requests to Se Hwan Hwang, M.D., Ph.D., Department of Otolaryngology–Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Republic of Korea; E-mail: yellobird@catholic.ac.kr

Sponsorships: None.

Author contributions: D.H.K. study conception and design, acquisition of data, analysis and interpretation of data, drafting the article and revisions, final approval of article. S.L., study conception and design, analysis and interpretation of data, drafting the article and revisions, final approval of article. S.H.H., study conception and design, acquisition of data, analysis and interpretation of data, drafting the article and revisions, final approval of article.

Funding: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2017R1D1A1B03027903, 2018R1D1A1B07045421), the Bio & Medical Technology Development Program of the NRF funded by the Ministry of Science & ICT (2018M3A9E8020856), and the Institute of Clinical Medicine Research of Bucheon St. Mary's Hospital, Research Fund (2017, 2018). This research was also supported by a grant from the E.N.T. Fund of the Catholic University of Korea (program years 2017–2018).

The authors disclose no conflicts of interest.

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