{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:02:32Z","timestamp":1781650952558,"version":"3.54.5"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>To find a more objective method of assessing which patients should be screened for a vestibular schwannoma (VS) with magnetic resonance imaging (MRI) using a deep-learning algorithm to assess clinical and audiometric data.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and Methods:<\/jats:title>\n            <jats:p>Clinical and audiometric data were collected for 592 patients who received an audiogram between January 2015 and 2020 at Duke University Health Center with and without VS confirmed by MRI. These data were analyzed using a deep learning-based analysis to determine if the need for MRI screening could be assessed more objectively with adequate sensitivity and specificity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Patients with VS showed slightly elevated, but not statistically significant, mean thresholds compared to those without. Tinnitus, gradual hearing loss, and aural fullness were more common in patients with VS. Of these, only the presence of tinnitus was statistically significant. Several machine learning algorithms were used to incorporate and model the collected clinical and audiometric data, but none were able to distinguish ears with and without confirmed VS. When tumor size was taken into account the analysis was still unable to distinguish a difference.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Using audiometric and clinical data, deep learning-based analyses failed to produce an adequately sensitive and specific model for the detection of patients with VS. This suggests that a specific pattern of audiometric asymmetry and clinical symptoms may not necessarily be predictive of the presence\/absence of VS to a level that clinicians would be comfortable forgoing an MRI.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ono.0000000000000028","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T19:03:33Z","timestamp":1678388613000},"page":"e028","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["MRI Screening in Vestibular Schwannoma: A Deep Learning-based Analysis of Clinical and Audiometric Data"],"prefix":"10.1097","volume":"3","author":[{"given":"Sarah","family":"Kortebein","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoujun","family":"Gu","sequence":"additional","affiliation":[{"name":"Auditory Development and Restoration Program, NIDCD Otolaryngology Surgeon-Scientist Program, Division of Intramural Research, NIDCD\/NIH, Bethesda, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristal","family":"Riska","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kaylie","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hoa","sequence":"additional","affiliation":[{"name":"Auditory Development and Restoration Program, NIDCD Otolaryngology Surgeon-Scientist Program, Division of Intramural Research, NIDCD\/NIH, Bethesda, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,3]]},"reference":[{"key":"R1-20241014","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1001\/jamaoto.2015.142","article-title":"Clinical predictors of abnormal magnetic resonance imaging findings in patients with asymmetric sensorineural hearing loss.","volume":"141","author":"Ahsan","year":"2015","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"R2-20241014","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/MAO.0b013e3181a5297a","article-title":"Asymmetric hearing loss: rule 3,000 for screening vestibular schwannoma.","volume":"30","author":"Saliba","year":"2009","journal-title":"Otol Neurotol"},{"key":"R3-20241014","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1177\/01945998211042006","article-title":"Global incidence of sporadic vestibular schwannoma: a systematic review.","volume":"167","author":"Marinelli","year":"2022","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R4-20241014","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1097\/MOO.0000000000000647","article-title":"Current imaging tools for vestibular schwannoma.","volume":"28","author":"Dang","year":"2020","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"key":"R5-20241014","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1002\/lary.27118","article-title":"Which patients with asymmetric sensorineural hearing loss should undergo imaging?.","volume":"128","author":"Gupta","year":"2018","journal-title":"Laryngoscope"},{"key":"R6-20241014","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s00405-010-1378-9","article-title":"Rule 3,000: a more reliable precursor to perceive vestibular schwannoma on MRI in screened asymmetric sensorineural hearing loss.","volume":"268","author":"Saliba","year":"2011","journal-title":"Eur Arch Oto-Rhino-Laryngology"},{"key":"R7-20241014","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1017\/S0022215112000680","article-title":"Incidence of vestibular schwannoma and incidental findings on the magnetic resonance imaging and computed tomography scans of patients from a direct referral audiology clinic.","volume":"126","author":"Wong","year":"2012","journal-title":"J Laryngol Otol"},{"key":"R9-20241014","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1002\/lary.24871","article-title":"Is gadolinium contrast enhancement necessary in screening MRI for asymmetric sensorineural hearing loss?","volume":"125","author":"Ryan","year":"2015","journal-title":"Laryngoscope"},{"key":"R10-20241014","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/j.1365-2273.2007.01460.x","article-title":"Screening patients with sensorineural hearing loss for vestibular schwannoma using a Bayesian classifier.","volume":"32","author":"Nouraei","year":"2007","journal-title":"Clin Otolaryngol"},{"key":"R11-20241014","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0194-5998(95)70101-X","article-title":"Committee on Hearing and Equilibrium guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma). American Academy of Otolaryngology\u2013Head and Neck Surgery.","volume":"113","year":"1995","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R12-20241014","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1177\/019459989010300305","article-title":"Acoustic neuroma: a cost-effective approach.","volume":"103","author":"Welling","year":"1990","journal-title":"Otolarynogology Head Neck Surg"},{"key":"R13-20241014","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1097\/MAO.0b013e31816c7c09","article-title":"Asymmetric hearing loss: definition, validation, and prevalence.","volume":"29","author":"Margolis","year":"2008","journal-title":"Otol Neurotol"},{"key":"R14-20241014","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/S0194-5998(99)70318-9","article-title":"Asymmetric sensorineural hearing loss in a community-based population.","volume":"120","author":"Urben","year":"1999","journal-title":"Otolaryngol Head Neck Surg"},{"key":"R15-20241014","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1044\/jshr.3805.1168","article-title":"Evaluating hearing threshold differences between ears as a screen for acoustic neuroma.","volume":"38","author":"Schlauch","year":"1995","journal-title":"J Speech Hear Res"},{"key":"R16-20241014","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1017\/S0022215100141891","article-title":"Audit of regional screening guidelines for vestibular schwannoma.","volume":"112","author":"Dawes","year":"1998","journal-title":"J Laryngol Otol"},{"key":"R17-20241014","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1097\/00005537-200410000-00003","article-title":"Auditory brainstem response versus magnetic resonance imaging for the evaluation of asymmetric sensorineural hearing loss.","volume":"114","author":"Cueva","year":"2004","journal-title":"Laryngoscope"},{"key":"R18-20241014","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1365-2273.1996.tb01074.x","article-title":"MRI in the detection of acoustic neuromas: a suggested protocol for screening.","volume":"21","author":"Sheppard","year":"1996","journal-title":"Clin Otolaryngol"},{"key":"R19-20241014","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1097\/00003446-199912000-00006","article-title":"Safety and clinical performance of acoustic reflex tests.","volume":"20","author":"Hunter","year":"1999","journal-title":"Ear Hear"},{"key":"R20-20241014","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1097\/MAO.0000000000001251","article-title":"Diagnostic criteria for detection of vestibular schwannomas in the VA population.","volume":"37","author":"Pena","year":"2016","journal-title":"Otol Neurotol"},{"key":"R21-20241014","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3390\/genes10020087","article-title":"Machine learning and integrative analysis of biomedical big data.","volume":"10","author":"Mirza","year":"2019","journal-title":"Genes (Basel)"},{"key":"R22-20241014","doi-asserted-by":"crossref","first-page":"e530","DOI":"10.1097\/MAO.0000000000003539","article-title":"Machine learning for vestibular schwannoma diagnosis using audiometrie data alone.","volume":"43","author":"Carey","year":"2022","journal-title":"Otol Neurotol"},{"key":"R23-20241014","first-page":"3845","article-title":"The proteome of human perilymph.","volume":"10","author":"Lysaght","year":"2011","journal-title":"NIH Public Access Author Manuscr"},{"key":"R24-20241014","first-page":"1","article-title":"Potential molecular biomarkers of vestibular schwannoma growth: progress and prospects.","volume":"11","author":"Zhang","year":"2021","journal-title":"Front Oncol"},{"key":"R25-20241014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fneur.2019.00978","article-title":"Biomarkers in vestibular schwannoma\u2013associated hearing loss.","volume":"10","author":"Lassaletta","year":"2019","journal-title":"Front Neurol"},{"key":"R26-20241014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/noajnl\/vdaa023","article-title":"The inflammatory microenvironment in vestibular schwannoma.","volume":"2","author":"Hannan","year":"2020","journal-title":"Neuro-Oncology Adv"}],"container-title":["Otology &amp; Neurotology Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/ONO.0000000000000028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T00:10:53Z","timestamp":1728951053000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/ONO.0000000000000028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1097\/ono.0000000000000028","relation":{},"ISSN":["2766-3604"],"issn-type":[{"value":"2766-3604","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}