Using Non-Contrast Magnetic Resonance Imaging for Detection of Vestibular Schwannoma Assessment: A Systematic Review and Diagnostic Accuracy Meta-Analysis

Abstract

Background and Aim: Non-contrast magnetic resonance imaging (MRI) offers high spatial resolution without the need for contrast agents and has been recognized as a useful imaging technique since the early 1990s. The study aimed to evaluate the effectiveness of T2wi compared to gadolinium-enhanced T1-weighted imaging in diagnosing VS. Methods: We performed a systematic search of literature in PubMed, Web of Science, and Scopus with relevant keywords. Studies that did not perform MRI or had insufficient data were excluded. Data extraction was performed based on a standardized sheet. Meta analysis was performed with STATA, R, and RStudio. Results: The initial search retrieved 6, 088 articles from which 1, 872 duplicates were removed. Finally, 10 studies were included based on our eligibility criteria. The pooled sensitivity of MRI in detection of vestibular schwannoma on patient level was 97% (95% CI: 82% - 100%, p-value < 0.01) and its specificity was 98% (95% CI: 89% - 100%, p-value < 0.01). The pooled sensitivity of MRI in detection of vestibular schwannoma on ear level was 98% (95% CI: 87% - 100%, p-value < 0.01) and its specificity on ear level was 99% (95% CI: 96% - 99%, p-value < 0.01). The pooled mean dice score was 87.42 (95%CI: 82-92). Conclusion: Non-contrast MR imaging offers precise evaluations of vestibular schwannoma in comparison to enhanced T1-weighted imaging. T2wi shows outstanding diagnostic precision for vestibular schwannomas and presents strong reliability in diagnostic evaluations.