Objective:

To examine current MRI surveillance strategies for sporadic VS, map their variability, and identify opportunities for optimization to standardize and improve resource efficiency.

Background:

Management of vestibular schwannomas, benign tumors with an estimated incidence of 3-5 cases per 100,000 annually, often involves surveillance. For smaller, asymptomatic tumors, a "wait and scan" approach using serial magnetic resonance imaging (MRI) is frequently adopted to avoid risks associated with interventions like surgery or radiation. Although contrast-enhanced MRI is standard, surveillance protocols vary significantly across institutions regarding scan frequency, duration, and techniques. This variability contributes to inconsistent patient management and resource use, highlighting the need for this scoping review to map current strategies and identify opportunities for optimization.

Design/Methods:

Following PRISMA-ScR guidelines, we systematically searched PubMed and Scopus for articles published in English between 2000 and 2025 using relevant keywords. We included prospective or retrospective studies that reported tumor change in sporadic (non-NF2) vestibular schwannomas monitored longitudinally with MRI (involving at least two scans). We excluded studies focusing solely on initial diagnosis, non-MRI techniques, post-treatment monitoring unrelated to surveillance strategies, or NF2 populations, as well as case reports, review articles and clinical guidelines. Two reviewers independently screened titles and abstracts, followed by full-text review; discrepancies were resolved by a third reviewer.

Results:

Our literature search yielded 514 articles. Following title and abstract screening, 30 articles were identified as potentially relevant and proceeded to full-text review. This review characterizes the MRI surveillance strategies reported within this body of literature, specifically mapping the heterogeneity in techniques, imaging protocols, scan frequencies, follow-up durations, and the methods used to define and measure tumor change.

Conclusions:

This scoping review provides a map of current MRI surveillance practices for vestibular schwannoma.  This overview will establish a foundation for future research aimed at optimizing surveillance protocols and potentially informing guideline development.