C.01 Cystic Vestibular Schwannomas respond best to radiosurgery
Bibliographic record
Abstract
Background: Vestibular Schwannomas (VS) have a well- documented response to Gamma Knife® Stereotactic radiosurgery (SRS). However, there is limited data available regarding the volumetric response of cystic tumors. This report correlates the radiographic appearance of VS before radiosurgery with the delayed volumetric response. Methods: This study reviewed 219 VS patients between 2003 and 2013. Patients were treatment naïve and had a significant extracanalicular tumor volume. MRI at SRS identified; 42 contrast enhancing macrocystic tumors, 45 contrast enhancing microcystic tumors, and 132 homogeneously enhancing tumors with no intra-tumoral cyst formation. The median follow-up was 49.1 months. The median tumor volume was 2.6cm3 (0.70-16.1cm3) and the median dose was 12.5Gy (11-13Gy). Results: The actuarial tumor control rate was 99.4% at 2-years and 96.4% at 5-years. A volumetric reduction of >20% occurred in 85.4% of macrocystic tumors, 76.1% of microcystic tumors and 62.8% of homogeneously enhancing VS. The median volume decrease per year for macrocystic, microcystic and homogenous tumors was 17.2%, 7.5% and 7.9% per year respectively (p<0.001). Serviceable hearing was maintained in 61.5% of patients that had Gardner-Robertson grade I-II hearing. Conclusions: SRS provided VS tumor control in >95% of patients, regardless of radiographic characteristics. Tumor volume regression was most evident in patients with cystic tumors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".