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Correlation between immunohistochemical markers affecting vascularity in vestibular schwannoma and arterial spin labelled imaging
Shrinath Jagat Shah, Manish Beniwal, Jitender Saini, B. N. Nandeesh, Abhinith Shashidhar, A. R. Prabhuraj, A. Arivazhagan, Dwarakanath Srinivas, Dhaval Shukla Objectives:
Hypervascular vestibular schwannoma is an entity characterized by excessive bleeding during surgical excision. This study aims to determine if the vestibular schwannoma has increased vascularity by identifying areas of increased vascularity on preoperative imaging and studying the expression of immunohistochemical (IHC) markers in post-operative biopsy specimen.
Materials and Methods:
A cross-sectional study of 31 patients with vestibular schwannoma meeting the inclusion criteria was undertaken. 31 patients underwent pre-operative imaging with arterial spin labelled (ASL) imaging, and relative tumor blood flow (rTBF) was determined using the ratio of TBF to regional cerebral blood flow (CBF) of gray matter (rTBF = TBF/CBF). Following surgical excision, the biopsy specimen was evaluated for expression of vascular endothelial growth factor (VEGF), Factor VIII, and CD31.
Results:
The mean rTBF was 1.56. The Spearman correlation coefficient between rTBF and VEGF, Factor VIII, and CD31 was 0.2 (P = 0.2), 0.3 (P = 0.106), and 0.3 (P = 0.146).
Conclusion:
A statistically significant positive correlation is obtained between IHC markers, i.e., CD31 and VEGF and between CD31 and Factor VIII. A positive correlation, although not statistically significant, is observed between increased vascularity on ASL and increased expression of IHC.
