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Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma
BACKGROUND: To evaluate whether functional and metabolic MRI can detect radiation-induced alterations in the adjacent areas after effective stereotactic radiosurgery (SRS) for brain metastases. If confirmed, these techniques may be suited for monitoring the timely stratification of patients for neur...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341877/ https://www.ncbi.nlm.nih.gov/pubmed/32362656 http://dx.doi.org/10.1038/s41416-020-0853-3 |
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author | Wagner, Sabine Lanfermann, Heinrich Wohlgemuth, Walter Alexander Gufler, Hubert |
author_facet | Wagner, Sabine Lanfermann, Heinrich Wohlgemuth, Walter Alexander Gufler, Hubert |
author_sort | Wagner, Sabine |
collection | PubMed |
description | BACKGROUND: To evaluate whether functional and metabolic MRI can detect radiation-induced alterations in the adjacent areas after effective stereotactic radiosurgery (SRS) for brain metastases. If confirmed, these techniques may be suited for monitoring the timely stratification of patients for neuroprotective treatments after irradiation. METHODS: Inclusion criteria were complete response, partial response, or stable disease on routine follow-up MR-scans. Multiparametric 3T-MRI was performed with diffusion-weighted imaging, dynamic susceptibility perfusion-weighted imaging, and two-dimensional proton MR-spectroscopy. Parameters were measured in the SRS-treated target and in the adjacent parenchyma up to both 0.75 cm and 1.5 cm from the target border. RESULTS: Nineteen lesions in sixteen consecutive patients met the inclusion criteria. The median follow-up time was 39 months (range, 10–142) with 41 multiparametric MR-examinations in total. We found low values of N-acetyl-aspartate up to 1.5 cm from the target borders of SRS (P = 0.043) associated with high values of choline (P = 0.004) at the end of the observation period. Lactate levels in the adjacent tissue declined over time, whereas continuously high apparent-diffusion-coefficient values were noted (P < 0.001). CONCLUSION: Multiparametric MRI can depict radiobiological effects and their time course at a distance from the effectively treated site after SRS for brain metastases, even if conventional MRI findings are inconspicuous. |
format | Online Article Text |
id | pubmed-7341877 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-73418772021-05-04 Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma Wagner, Sabine Lanfermann, Heinrich Wohlgemuth, Walter Alexander Gufler, Hubert Br J Cancer Article BACKGROUND: To evaluate whether functional and metabolic MRI can detect radiation-induced alterations in the adjacent areas after effective stereotactic radiosurgery (SRS) for brain metastases. If confirmed, these techniques may be suited for monitoring the timely stratification of patients for neuroprotective treatments after irradiation. METHODS: Inclusion criteria were complete response, partial response, or stable disease on routine follow-up MR-scans. Multiparametric 3T-MRI was performed with diffusion-weighted imaging, dynamic susceptibility perfusion-weighted imaging, and two-dimensional proton MR-spectroscopy. Parameters were measured in the SRS-treated target and in the adjacent parenchyma up to both 0.75 cm and 1.5 cm from the target border. RESULTS: Nineteen lesions in sixteen consecutive patients met the inclusion criteria. The median follow-up time was 39 months (range, 10–142) with 41 multiparametric MR-examinations in total. We found low values of N-acetyl-aspartate up to 1.5 cm from the target borders of SRS (P = 0.043) associated with high values of choline (P = 0.004) at the end of the observation period. Lactate levels in the adjacent tissue declined over time, whereas continuously high apparent-diffusion-coefficient values were noted (P < 0.001). CONCLUSION: Multiparametric MRI can depict radiobiological effects and their time course at a distance from the effectively treated site after SRS for brain metastases, even if conventional MRI findings are inconspicuous. Nature Publishing Group UK 2020-05-04 2020-07-07 /pmc/articles/PMC7341877/ /pubmed/32362656 http://dx.doi.org/10.1038/s41416-020-0853-3 Text en © The Author(s), under exclusive licence to Cancer Research UK 2020 https://creativecommons.org/licenses/by/4.0/Note This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution 4.0 International (CC BY 4.0). |
spellingShingle | Article Wagner, Sabine Lanfermann, Heinrich Wohlgemuth, Walter Alexander Gufler, Hubert Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma |
title | Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma |
title_full | Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma |
title_fullStr | Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma |
title_full_unstemmed | Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma |
title_short | Effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma |
title_sort | effects of effective stereotactic radiosurgery for brain metastases on the adjacent brain parenchyma |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341877/ https://www.ncbi.nlm.nih.gov/pubmed/32362656 http://dx.doi.org/10.1038/s41416-020-0853-3 |
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