Diagnostic Test Validation: FIESTA Sequence of Magnetic Resonance Imaging in Vestibular Schwannoma Diagnosis

Objective: To determine the test accuracy of noncontrast magnetic resonance imaging with FIESTA sequence (FIESTA-MRI), comparing with gadolinium-contrasted MRI including FIESTA sequence (Gd-MRI), in the diagnosis of vestibular schwannoma (VS). Study Design: Diagnostic accuracy study, phase-IIc. Methods: We estimated the FIESTA-MRI performance in the diagnosis of VS, using the Gd-MRI as gold standard. The test accuracy indicators were assessed in adult patients with suspected VS at tertiary referral center, from January 2006 to December 2011. The MRIs were acquired with a standardized protocol and evaluated blindly and independently by two neuroradiologists, using a random codes assignment of each unit of observation. The reproducibility assessment was calculated with the Cohen Kappa interrater agreement coefficient. Results: We included 85 patients, 26 of them had VS and 59 did not. The sensitivity of FIESTA-MRI was84.6% (CI 95% = 68.8-100%), specificity was 100% (CI95% = 99.1-100%), negative predictive value was93.6% (CI 95% = 86.8-100%), and positive predictive value was 100% (CI95% = 97.7-100%). The interrater agreement coefficient was0.91 (CI 95% = 0.81-1.00), Cohen Kappa, p < 0.001. Conclusions: The FIESTA-MRI is a reliability test as a first approach in suspected SV patients.