Can Standard Magnetic Resonance Imaging Reliably Distinguish Recurrent Tumor From Radiation Necrosis After Radiosurgery for Brain Metastases? A Radiographic-Pathological Study

DeQuesada, Ivan M.; Quisling, Ronald G.; Yachnis, Anthony T.; Friedman, William A.

doi:10.1227/01.neu.0000333263.31870.31

Cited by 158 publications

(78 citation statements)

References 36 publications

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“…Observation may be considered in asymptomatic patients, whereas steroids and surgical decompression are usually offered to patients with neurological deterioration. In this regard, however, despite several attempts at finding reliable parameters [32,33], conventional MRI has proven to be insufficient and alternative technique are needed [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of F-DOPA PET and perfusion-MRI for differentiating radionecrotic from progressive brain metastases after radiosurgery

Cicone

Minniti

Romano

et al. 2014

Eur J Nucl Med Mol Imaging

128

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Section: Discussionmentioning

confidence: 99%

Accuracy of F-DOPA PET and perfusion-MRI for differentiating radionecrotic from progressive brain metastases after radiosurgery

Cicone

Minniti

Romano

et al. 2014

Eur J Nucl Med Mol Imaging

128

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“…Many studies have reported variable degrees of diagnostic sensitivity and specificity using various MR imaging sequences and positron-emission tomography imaging techniques, but consensus does not exist. 15,16 Historically, at our center, patients whose serial MR images post-SRS demonstrated both progressively increasing lesion size and increasing surrounding FLAIR signal-intensity abnormality were sent for brain FDG-PET and/or proton MR spectroscopy and DWI. If any of these scan results were positive or conflicting, a surgical biopsy or resection was performed.…”

mentioning

confidence: 99%

A Comprehensive Review of MR Imaging Changes following Radiosurgery to 500 Brain Metastases

Patel

McHugh

et al. 2011

AJNR Am J Neuroradiol

141

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“…In total, 406 scans were evaluated. Patients with tumor growth were treated with surgery or WBRT [31] .…”

Section: Resultsmentioning

confidence: 99%

Radiographic Response of Brain Metastasis after Linear Accelerator Radiosurgery

Rahman

Cox

Yun

et al. 2012

Stereotact Funct Neurosurg

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Background: Radiographic response of brain metastasis to stereotactic radiosurgery (SRS) over time has not been well characterized. Being able to predict SRS-induced changes in tumor size over time may allow improved counseling of patients and potentially earlier recognition of poor response to SRS. Objective: To quantify the rate of change in size of metastatic brain tumors after treatment with a linear accelerator (LINAC) SRS. Methods: We performed a retrospective analysis of patients with single metastatic brain tumors treated with LINAC SRS at the University of Florida between 1992 and 2009 who had at least one MRI after treatment. A total of 218 patients with 406 follow-up MRI scans were included in the study. Tumor area was calculated by measuring the largest tumor area on axial imaging and using the equation for area of an ellipse. Primary outcome was percent change in tumor size. The contribution of several factors including gender, primary tumor histology, synchronous or asynchronous presentation, prior treatment, primary tumor control, and SRS dose were examined using multivariate analysis. Results: Mean patient age was 58.3 years (range 4–86), and 48.6% of patients were female. Sixty-three percent of patients had primary tumor control and 70.6% had asynchronous presentation of their brain metastases. SRS peripheral dose range was 1,000–2,250 cGy with a median of 1,750 cGy. The mean percent size change was –22.6% with a mean rate of change of –7.0% per month. The median percent change was –49.7% with a median rate of change of –8.8% per month. The median follow-up was 4.8 months (range 0.3–52.5). Female gender and melanoma histology were found to be significant predictors of an increase in tumor size. Lack of previous surgical resection was a significant predictor of a decrease in tumor size after SRS. Other factors tested with multivariate analysis, including age, synchronicity of presentation, dose, dose volume, Karnofsky performance score, and primary tumor control, were not significant in predicting tumor size change after SRS. Conclusion: In this study, brain metastases decreased in size by a median of 50% for a median follow-up of 4.8 months after SRS. The overall rate of decrease was 9% per month after treatment with SRS. Melanoma histology was a predictor of poor tumor control.

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Can Standard Magnetic Resonance Imaging Reliably Distinguish Recurrent Tumor From Radiation Necrosis After Radiosurgery for Brain Metastases? A Radiographic-Pathological Study

Cited by 158 publications

References 36 publications

Accuracy of F-DOPA PET and perfusion-MRI for differentiating radionecrotic from progressive brain metastases after radiosurgery

Accuracy of F-DOPA PET and perfusion-MRI for differentiating radionecrotic from progressive brain metastases after radiosurgery

A Comprehensive Review of MR Imaging Changes following Radiosurgery to 500 Brain Metastases

Radiographic Response of Brain Metastasis after Linear Accelerator Radiosurgery

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