Assessment of irradiated brain metastases using dynamic contrast-enhanced magnetic resonance imaging

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Citações na Scopus
23
Tipo de produção
article
Data de publicação
2014
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Citação
NEURORADIOLOGY, v.56, n.6, p.437-443, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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.
Palavras-chave
Brain metastasis, MRI, Stereotactic radiosurgery, Brain tumor
Referências
  1. Cao Y, 2009, CLIN CANCER RES, V15, P1747, DOI 10.1158/1078-0432.CCR-08-1420
  2. Carr JP, 2007, MAGN RESON MED, V58, P281, DOI 10.1002/mrm.21317
  3. Essig M, 2003, RADIOLOGY, V228, P193, DOI 10.1148/radiol.2281020298
  4. Gao X, 2011, CHINESE MED J-PEKING, V124, P1906, DOI 10.3760/cma.j.issn.0366-6999.2011.12.025
  5. Huang CF, 2008, SURG NEUROL, V69, P62, DOI 10.1016/j.surneu.2007.02.021
  6. Huber PE, 2001, INT J RADIAT ONCOL, V49, P1339, DOI 10.1016/S0360-3016(00)01511-X
  7. Kang TW, 2009, EUR J RADIOL, V72, P370, DOI 10.1016/j.ejrad.2008.08.009
  8. Kassner A, 2011, METHODS MOL BIOL, V686, P229, DOI 10.1007/978-1-60761-938-3_10
  9. Lacerda S, 2009, NEUROIMAG CLIN N AM, V19, P527, DOI 10.1016/j.nic.2009.08.007
  10. Peng SL, 2012, NMR BIOMED
  11. Peterson AM, 1999, RADIOLOGY, V211, P807
  12. Provenzale JM, 2005, AM J ROENTGENOL, V185, P763
  13. Rahman M, 2012, STEREOT FUNCT NEUROS, V90, P69, DOI 10.1159/000334669
  14. Ranjan T, 2009, NEUROTHERAPEUTICS, V6, P598, DOI 10.1016/j.nurt.2009.04.012
  15. Ross DA, 2002, J NEURO-ONCOL, V56, P175, DOI 10.1023/A:1014571900854
  16. Shah R, 2012, RADIOGRAPHICS, V32, P1343, DOI 10.1148/rg.325125002
  17. Shinoda Jun, 2002, Brain Tumor Pathol, V19, P83, DOI 10.1007/BF02478932
  18. Suh JH, 2010, NEW ENGL J MED, V362, P1119, DOI 10.1056/NEJMct0806951
  19. Thompson G, 2010, NEUROIMAG CLIN N AM, V20, P337, DOI 10.1016/j.nic.2010.04.008
  20. TOFTS PS, 1991, MAGNET RESON MED, V17, P357, DOI 10.1002/mrm.1910170208
  21. Weltman E, 2000, INT J RADIAT ONCOL, V46, P1155, DOI 10.1016/S0360-3016(99)00549-0
  22. Zaharchuk G, 2007, AM J NEURORADIOL, V28, P1850, DOI 10.3174/ainr.A0831
  23. Zhang N, 2012, J MAGN RESON IMAGING, V36, P355, DOI 10.1002/jmri.23675