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Related Experiment Video

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Modeling Brain Metastases Through Intracranial Injection and Magnetic Resonance Imaging
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Diameter-Based Volumetric Models May Inadequately Calculate Jugular Paraganglioma Volume Following Sub-Total

Douglas J Totten1, Alexander D Sherry1, Nauman F Manzoor2

  • 1Vanderbilt University School of Medicine.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|June 21, 2021
PubMed
Summary
This summary is machine-generated.

Diameter-based models for jugular paraganglioma (JP) tumor volume are inaccurate. Slice-by-slice segmentation offers a more precise method for assessing residual tumor growth after subtotal resection (STR).

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Area of Science:

  • Neurosurgery
  • Radiology
  • Oncology

Background:

  • Jugular paragangliomas (JPs) are often managed with subtotal resection (STR) to avoid cranial nerve deficits.
  • Postoperative radiological monitoring is used to assess residual tumor growth.
  • Diameter-based models for estimating tumor volume lack proven validity.

Purpose of the Study:

  • To assess the accuracy of commonly used diameter-based volumetric models for jugular paragangliomas (JPs).
  • To compare these models against manual volumetric slice-by-slice segmentation for residual tumor assessment.

Main Methods:

  • Volumetric measurements of JPs were performed using slice-by-slice segmentation by a senior neuroradiologist.
  • Three linear-based models (cuboidal, ellipsoidal, spherical) were used to calculate postoperative volumes.
  • Absolute percent error (APE) > 20% was considered unsatisfactory; Bland-Altman plots and Wilcoxon signed rank test evaluated bias and reproducibility.

Main Results:

  • Median postoperative APE exceeded 20% for all models: cuboidal (63%), ellipsoidal (28%), and spherical (27%).
  • The cuboidal model showed significant overestimation bias (p=0.002).
  • Ellipsoidal and spherical models lacked significant systematic bias (p=0.11 and p=0.82, respectively).

Conclusions:

  • Linear-based models (cuboidal, ellipsoidal, spherical) are inaccurate for assessing postoperative JP tumor volume.
  • Inaccurate volume assessment can lead to inappropriate treatment decisions regarding salvage therapies.
  • Slice-by-slice segmentation by an experienced neuroradiologist provides a more accurate and precise measurement for optimizing clinical management.