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J Neurol Surg A Cent Eur Neurosurg 2020; 81(03): 213-219
DOI: 10.1055/s-0039-1696680
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Quantitative Analysis of Superb Microvascular Imaging versus Color-Coded Doppler Sonography for Preoperative Evaluation of Vascularization of Schwannomas

Christopher Kloth
1   Department of Diagnostic and Interventional Radiology, Universitaet Ulm Medizinische Fakultaet, Ulm, Baden-Württemberg, Germany
,
Alexandra Eissler
2   Department of Internal Medicine I, Universitaet Ulm Medizinische Fakultaet, Ulm, Baden-Württemberg, Germany
,
Julian Schmidberger
2   Department of Internal Medicine I, Universitaet Ulm Medizinische Fakultaet, Ulm, Baden-Württemberg, Germany
,
Tillmann Gräter
1   Department of Diagnostic and Interventional Radiology, Universitaet Ulm Medizinische Fakultaet, Ulm, Baden-Württemberg, Germany
,
Angelika Scheuerle
3   Department of Neuropathology, Universitaet Ulm Medizinische Fakultaet, Ulm, Baden-Württemberg, Germany
,
Wolfgang Kratzer
2   Department of Internal Medicine I, Universitaet Ulm Medizinische Fakultaet, Ulm, Baden-Württemberg, Germany
,
Maria Teresa Pedro
4   Department of Neurosurgery, University of Ulm, Guenzburg, Germany
› Author Affiliations
Further Information

Publication History

27 January 2019

30 April 2019

Publication Date:
27 November 2019 (online)

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Abstract

Purpose Comparison of vascularization of schwannomas, benign peripheral nerve sheath tumors, using color-coded Doppler sonography (CCDS) and the Toshiba monochrome Superb Microvascular Imaging (mSMI) (Minato, Tokyo, Japan) technique.

Methods In a retrospective single-center analysis, 16 patients were identified with histologically confirmed schwannomas. Between March and June 2018, all of them underwent ultrasonography using mSMI and CCDS before surgery. Schwannoma vascularization was quantitatively measured using ImageJ, an open platform for scientific image analysis. As the diagnostic gold standard, magnetic resonance imaging was mandatory.

Results The mSMI and CCDS vascularization showed a moderate agreement between the techniques (κ = 0.5556; p = 0.0066). The quantitative visual assessment of the vascularization revealed no difference (25.3 ± 8.2 vs. 18.2 ± 3.8; p = 0.0532). Significant differences were found for the quantitative assessment of CCDS with ImageJ (26.8 ± 8.8 vs. 19.3 ± 2.8; p = 0.0368). However, in a subanalysis of highly vascularized schwannomas, mSMI revealed significant differences to slightly vascularized schwannomas (32.0 ± 8.2 vs. 21.3 ± 6.1; p = 0.0065) but not between moderately and slightly vascularized types (p = not significant).

Conclusion The mSMI mode is qualitatively superior to conventional CCDS; however, quantitative analysis of the vascularization of schwannomas revealed no significant quantitative advantage for mSMI. Nevertheless, the mean ImageJ values showed a positive trend toward a better representation of the vascularization degree of schwannomas with mSMI.

Keywords

schwannoma - neurosonography - monochrome Superb Microvascular Imaging - benign peripheral nerve sheath tumor

Ethical Statement

The study was approved by the local ethics committee and was conducted in accordance with the Declaration of Helsinki (Ref. no. 115/18). Informed consent was obtained from all patients before inclusion in the study.


 

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