{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:57:30Z","timestamp":1790686650213,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Increased MRI use for nonspecific symptoms has led to frequent detection of small or incidental vestibular schwannomas (VS), most of which never require treatment. This study aimed to develop and validate a stepwise model to stratify VS patients using early MRI findings and reduce unnecessary long\u2010term surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective multicenter cohort study with external validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Three tertiary referral centers in France (Strasbourg, Angers) and Switzerland (Frauenfeld).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients aged \u226518 years with sporadic VS and \u22653 consecutive MRIs before any intervention were included (2000\u20102020). Prior treatment, intralabyrinthine schwannomas, or incomplete imaging led to exclusion. A training cohort (n\u2009=\u2009156) and an independent validation cohort (n\u2009=\u200932) were analyzed. Logistic regression and random forest models were used to identify predictors of treatment. A clinically applicable stepwise algorithm integrating baseline tumor volume, annual growth rate, and symptom presence was developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The optimized model achieved 100% sensitivity in both cohorts, ensuring no patient requiring treatment was missed. Specificity was 74% in the training cohort and 48% in the validation cohort. After 1 follow\u2010up MRI, surveillance could be safely discontinued in half of the cohorts (respectively 74% and 48% of patients). Larger baseline tumor volume, symptom presence, and higher growth rate were significant predictors of treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A stratified, stepwise approach enables safe reduction of long\u2010term MRI surveillance in approximately half of VS patients, supporting personalized follow\u2010up and more efficient healthcare use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70481","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:09:22Z","timestamp":1790683762000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Are We Overmonitoring Vestibular Schwannomas? Challenging the Necessity of Tracking Them All"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0608-2353","authenticated-orcid":false,"given":"A\u00efna","family":"Venkatasamy","sequence":"first","affiliation":[{"name":"Departement of Radiology H\u00f4pital Europ\u00e9en Georges Pompidou, APHP Paris France"},{"name":"In vivo Imaging Research lab, UMR\u2010S970, PARCC Universit\u00e9 Paris Cit\u00e9 Paris France"},{"name":"Department of Radiology Medical Physics, Faculty of Medicine Medical Center\u2010University of Freiburg, University of Freiburg Killianstrasse 5a Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0445-4662","authenticated-orcid":false,"given":"Anne R. J.","family":"P\u00e9port\u00e9","sequence":"additional","affiliation":[{"name":"Department of Radiology Cantonal Hospital Frauenfeld Frauenfeld Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5075-3076","authenticated-orcid":false,"given":"Romain","family":"Kania","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Skull Base Center Assistance Publique H\u00f4pitaux de Paris  France"},{"name":"Facult\u00e9 de M\u00e9decine Universit\u00e9 Paris Cit\u00e9 Paris France"},{"name":"UMR 1141 Universit\u00e9 Paris Cit\u00e9 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1036-8293","authenticated-orcid":false,"given":"Jean\u2010Yves","family":"Tanguy","sequence":"additional","affiliation":[{"name":"Department of Radiology Centre Hospitalier Universitaire d'Angers Angers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0050-8608","authenticated-orcid":false,"given":"Beno\u00eet","family":"Gallix","sequence":"additional","affiliation":[{"name":"Department of Radiology American Hospital of Paris Neuilly\u2010sur\u2010Seine France"},{"name":"Facult\u00e9 de m\u00e9decine Universit\u00e9 de Strasbourg Strasbourg France"},{"name":"Department of Radiology McGill University Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211042006"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002542"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-020-04491-7"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noz153"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3171\/2022.1.JNS211544"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2016.05.003"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noab303"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.12222"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200606000-00018"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200503000-00011"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002626"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815590105"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001219"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16213718"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-025-06522-7"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noaa230"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000001414"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000003551"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2023.3485"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26589"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001999"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13691"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820986564"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1678708"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3181de46ae"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06530-6"},{"issue":"1","key":"e_1_2_9_28_1","first-page":"vdad144","article-title":"Wait\u2010and\u2010scan management in sporadic Koos grade 4 vestibular schwannomas: a longitudinal volumetric study","volume":"6","author":"Schouten SM","year":"2023","journal-title":"Neurooncol Adv"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.290"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1159\/000531337"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003055"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-4865-z"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2024.04.145"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx510"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003043"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70481","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70481","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70481","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:09:23Z","timestamp":1790683763000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":34,"alternative-id":["10.1002\/ohn.70481"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70481","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2026-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ohn.70481"}}