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Title: Assessment of irradiated brain metastases using dynamic contrast-enhanced magnetic resonance imaging
Authors: Almeida-Freitas, Daniela B.
Pinho, Marco C.
Otaduy, Maria C. G.
Braga, Henrique F.
Meira-Freitas, Daniel [UNIFESP]
Leite, Claudia da Costa
Universidade de São Paulo (USP)
Univ Calif San Diego
Univ Texas SW Med Ctr Dallas
Universidade Federal de São Paulo (UNIFESP)
Keywords: Brain metastasis
Stereotactic radiosurgery
Brain tumor
Issue Date: 1-Jun-2014
Publisher: Springer
Citation: Neuroradiology. New York: Springer, v. 56, n. 6, p. 437-443, 2014.
Abstract: The purpose of this study was to evaluate the effect of stereotactic radiosurgery (SRS) on cerebral metastases using the transfer constant (K (trans)) assessed by dynamic contrast-enhanced (DCE) MRI. Furthermore, we aimed to evaluate the ability of K (trans) measurements to predict midterm tumor outcomes after SRS.The study received institutional review board approval, and informed consent was obtained from all subjects. Twenty-six adult patients with a total of 34 cerebral metastases underwent T1-weighted DCE MRI in a 1.5-T magnet at baseline (prior to SRS) and 4-8 weeks after treatment. Quantitative analysis of DCE MRI was performed by generating K (trans) parametric maps, and region-of-interest-based measurements were acquired for each metastasis. Conventional MRI was performed at least 16 weeks after SRS to assess midterm tumor outcome using volume variation.The mean (+/- SD) K (trans) value was 0.13 +/- 0.11 min(-1) at baseline and 0.08 +/- 0.07 min(-1) after 4-8 weeks post-treatment (p < 0.001). the mean (+/- SD) total follow-up time was 7.9 +/- 4.7 months. Seventeen patients (22 lesions) underwent midterm MRI. of those, nine (41 %) lesions had progressed at the midterm follow-up. An increase in K (trans) after SRS was predictive of tumor progression (hazard ratio = 1.50; 95 % CI = 1.16-1.70, p < 0.001). An increase of 15 % in K (trans) showed a sensitivity of 78 % and a specificity of 85 % for the prediction of progression at midterm follow-up.SRS was associated with a reduction of K (trans) values of the cerebral metastases in the early post-treatment period. Furthermore, K (trans) variation as assessed using DCE MRI may be helpful to predict midterm outcomes after SRS.
ISSN: 0028-3940
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