MRI Texture Features are Associated with Vestibular Schwannoma Histology

Objectives/Hypothesis: To determine if commonly used radiomics features have an association with histological findings in vestibular schwannomas (VS). Study Design: Retrospective case-series. Methods: Patients were selected from an internal database of those who had a gadolinium-enhanced T1-weighted MRI scan captured prior to surgical resection of VS. Texture features from the presurgical magnetic resonance image (MRI) were extracted, and pathologists examined the resected tumors to assess for the presence of mucin, lymphocytes, necrosis, and hemosiderin and used a validated computational tool to determine cellularity. Sensitivity, specificity, and positive likelihood ratios were also computed for selected features using the Youden index to determine the optimal cut-off value. Results: A total of 45 patients were included. We found significant associations between multiple MRI texture features and the presence of mucin, lymphocytes, hemosiderin, and cellularity. No significant associations between MRI texture features and necrosis were identified. We were able to identify significant positive likelihood ratios using Youden index cut-off values for mucin (2.3; 95% CI 1.2–4.3), hemosiderin (1.5; 95% CI 1.04–2.1), lymphocytes (3.8; 95% CI 1.2–11.7), and necrosis (1.5; 95% CI 1.1–2.2). Conclusions: MRI texture features are associated with underlying histology in VS. Level of Evidence: 3 Laryngoscope, 131:E2000–E2006, 2021.