AI Article Synopsis
- This study investigates the correlation between early changes in perfusion MRI after stereotactic radiosurgery (SRS) and long-term outcomes in patients with lung cancer brain metastases.
- A total of 53 lesions from 41 patients were monitored, revealing that a specific MRI measurement (Ktrans SD) was notably different between patients with and without progressive disease, suggesting its potential as an early predictive biomarker.
- The findings suggest that posttreatment Ktrans SD could help identify patients who might experience treatment failure, prompting earlier adjustments in their treatment plans; however, further studies with larger groups are needed to confirm these results.
Article Abstract
Background: Imaging criteria to evaluate the response of brain metastases to stereotactic radiosurgery (SRS) in the early posttreatment period remains a crucial unmet need. The aim of this study is to correlate early (within 12 wk) posttreatment perfusion MRI changes with long-term outcomes after treatment of lung cancer brain metastases with SRS.
Methods: Pre- and posttreatment perfusion MRI scans were obtained in patients treated with SRS for intact non-small cell lung cancer brain metastases. Time-dependent leakage (Ktrans), blood plasma volume (Vp), and extracellular extravascular volume (Ve) were calculated for each lesion. Patients were followed longitudinally with serial MRI until death, progression, or intervention (whole brain radiation or surgery).
Results: We included 53 lesions treated with SRS from 41 total patients. Median follow-up after treatment was 11 months. Actuarial local control at one year was 85%. Univariate analysis demonstrated a significant difference (P = 0.032) in posttreatment Ktrans SD between patients with progressive disease (mean = 0.0317) and without progressive disease (mean = 0.0219). A posttreatment Ktrans SD cutoff value of 0.017 was highly sensitive (89%) for predicting progressive disease and no progressive disease. Early posttreatment volume change was not associated with outcome (P = 0.941).
Conclusion: Posttreatment Ktrans SD may be used as an early posttreatment imaging biomarker to help predict long-term response of lung cancer brain metastases to SRS. This can help identify patients who will ultimately fail SRS and allow for timelier adjustment in treatment approach. These data should be prospectively validated in larger patient cohorts and other histologies.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909646 | PMC |
| http://dx.doi.org/10.1093/neuonc/nox159 | DOI Listing |
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