Brain metastasis growth on preradiosurgical magnetic resonance imaging

Practical Radiation Oncology
Michael A GarciaSteve E Braunstein

Abstract

A previous analysis showed that brain metastases that are treated with frameless stereotactic radiation surgery (SRS) and planned with magnetic resonance imaging (MRI) >14 days before SRS had worse local control (LC). To evaluate if worse LC may be due to unaccounted interval metastasis growth and radiosurgical marginal miss, we quantified growth before SRS on preradiosurgical imaging. We reviewed data from patients who were treated with fixed-frame SRS for brain metastases at our institution between 2010 and 2013 and had pretreatment diagnostic brain MRI and SRS-planning MRI scans available. Metastases were contoured on the pretreatment MRI scan and the day-of-treatment planning MRI scan for volumetric comparison. Growth rates were calculated. Serial volumetric contour expansions on the pretreatment MRI scans were used to determine the minimum margin necessary to encompass the entire metastasis on day of the SRS. LC was estimated by Kaplan-Meier method. Among 411 brain metastases in 165 patients, the time between pretreatment and treatment MRI was associated with metastasis growth (P < .001) with a mean growth rate of 0.02 ml/day (95% confidence interval, 0.01-0.03) and a 1.35-fold volume increase at 14 days. Time between MRI ...Continue Reading

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Citations

Mar 25, 2020·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Florian PutzChristoph Bert
Dec 1, 2020·World Neurosurgery·Ronald J BenvenisteTejan Diwanji
Jun 15, 2021·Advances in Radiation Oncology·Sara L ThrowerCaroline Chung

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