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Diffusion and perfusion MRI predicts response preceding and shortly after stereotactic radiosurgery to brain metastases
Amaresha Shridhar Konar1, Akash Deelip Shah2, Ramesh Paudyal1, Jung Hun Oh1, Eve LoCastro1, David Aramburu Nuñez1, Nathaniel Swinburne2, Robert J. Young2, Andrei I. Holodny2, Kathryn Beal3, Vaios Hatzoglou2, and Amita Shukla-Dave1,2
1Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 2Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 3Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
The present prospective study aims to determine the ability of DW- and DCE-MRI to predict the long-term response of Brain Metastases within 72 hours of SRS. The results are promising as it will inform the treating physicians at an early time point about which patients will benefit from SRS (or not).
Figure 1: Representative pre-SRS and post-SRS (within 72 hours of treatment) MR images from an 80 year-old female with right occipital lobe brain metastasis, which demonstrated progressive disease (PD). Top panel: D(×10-3 mm2/s), D*(×10-3 mm2/s), and f maps are zoomed in at the locations of ROIs (pre-SRS b=0 s/mm2 image). The lesion volume was unchanged at post-SRS. Bottom panel: Ktrans (min-1), ve, and vp maps are zoomed in at the locations of ROIs (pre-SRS T1-postcontrast image).
Figure 4: Lesions that progressed had a higher f mean and median than those that did not. Lesions that responded to SRS had a lower pre-SRS Ktrans mean, Ktrans median, and ve median than those that did not. ADC mean and median trended higher in lesions post-SRS than pre-SRS. vp was lower in lesions post-SRS than pre-SRS. ADC, apparent diffusion coefficient. Ktrans, index of tumor vascular permeability. ve, volume fraction of extracellular extravascular space. vp, vascular volume.