Sabine Wagner1,2, Heinrich Lanfermann1,3, Gerrit Eichner4, Hubert Gufler5. 1. Institute of Neuroradiology, Johann-Wolfgang-Goethe University Frankfurt, Frankfurt/Main, Germany. 2. Department of Neuroradiology, Friedrich-Schiller-University Jena, Jena, Germany. 3. Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany. 4. Mathematical Institute, Justus-Liebig-University Giessen, Giessen, Germany. 5. Department of Diagnostic Radiology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
Abstract
Background: We sought to determine whether radiation-induced injuries could be distinguished from malignancy after stereotactic radiosurgery (SRS) by analyzing time-dependent changes in lesion morphology on sequential MRI for up to 55min. Methods: In 31 consecutive patients treated with SRS for brain metastases, the time-dependent changes in lesion morphology were analyzed on MRI 2min, 15min, and 55min after contrast administration and on subtraction images. A simultaneous, matched-pairs approach was used for quantitative region of interest analysis of the area of the lesion. Qualitative analysis comprised the shape of the border, the structure of the interior area, the presence of leptomeningeal enhancement, and feeding vessels. The signal intensity changes of the border and the interior area of the lesions over time were assessed visually. The time-dependent changes in the 2 entities were compared. Results: Twenty radiation-induced injuries and 21 malignancies were analyzed. A significant interaction effect between time point and diagnosis (P<.001) was found for the time-dependent changes of the margin of the lesion for 2min to 15min and in signal intensity differences of the rim and interior area as well as of the size of the interior area for up to 55min. All radiation-induced injuries showed a black interior area on the subtraction images for 15min minus 55min, whereas all malignant lesions had white components (P<.001). Conclusions: Analysis of time-dependent changes in lesion morphology on sequential MRI for up to 55min is a reliable tool to distinguish radiation-induced injuries from malignancy after SRS.
Background: We sought to determine whether radiation-induced injuries could be distinguished from malignancy after stereotactic radiosurgery (SRS) by analyzing time-dependent changes in lesion morphology on sequential MRI for up to 55min. Methods: In 31 consecutive patients treated with SRS for brain metastases, the time-dependent changes in lesion morphology were analyzed on MRI 2min, 15min, and 55min after contrast administration and on subtraction images. A simultaneous, matched-pairs approach was used for quantitative region of interest analysis of the area of the lesion. Qualitative analysis comprised the shape of the border, the structure of the interior area, the presence of leptomeningeal enhancement, and feeding vessels. The signal intensity changes of the border and the interior area of the lesions over time were assessed visually. The time-dependent changes in the 2 entities were compared. Results: Twenty radiation-induced injuries and 21 malignancies were analyzed. A significant interaction effect between time point and diagnosis (P<.001) was found for the time-dependent changes of the margin of the lesion for 2min to 15min and in signal intensity differences of the rim and interior area as well as of the size of the interior area for up to 55min. All radiation-induced injuries showed a black interior area on the subtraction images for 15min minus 55min, whereas all malignant lesions had white components (P<.001). Conclusions: Analysis of time-dependent changes in lesion morphology on sequential MRI for up to 55min is a reliable tool to distinguish radiation-induced injuries from malignancy after SRS.
Authors: Hideyuki Kano; Douglas Kondziolka; Javier Lobato-Polo; Oscar Zorro; John C Flickinger; L Dade Lunsford Journal: Neurosurgery Date: 2010-03 Impact factor: 4.654
Authors: P Van Tassel; J M Bruner; M H Maor; N E Leeds; M J Gleason; W K Yung; V A Levin Journal: AJNR Am J Neuroradiol Date: 1995-04 Impact factor: 3.825
Authors: David Israeli; David Tanne; Dianne Daniels; David Last; Ran Shneor; David Guez; Efrat Landau; Yiftach Roth; Aharon Ocherashvilli; Mati Bakon; Chen Hoffman; Amit Weinberg; Talila Volk; Yael Mardor Journal: Int J Biol Sci Date: 2010-12-26 Impact factor: 6.580
Authors: Anna K Heye; Ross D Culling; Maria Del C Valdés Hernández; Michael J Thrippleton; Joanna M Wardlaw Journal: Neuroimage Clin Date: 2014-09-10 Impact factor: 4.881
Authors: Timothy J Kaufmann; Marion Smits; Jerrold Boxerman; Raymond Huang; Daniel P Barboriak; Michael Weller; Caroline Chung; Christina Tsien; Paul D Brown; Lalitha Shankar; Evanthia Galanis; Elizabeth Gerstner; Martin J van den Bent; Terry C Burns; Ian F Parney; Gavin Dunn; Priscilla K Brastianos; Nancy U Lin; Patrick Y Wen; Benjamin M Ellingson Journal: Neuro Oncol Date: 2020-06-09 Impact factor: 12.300
Authors: Balamurugan A Vellayappan; Tresa McGranahan; Jerome Graber; Lynne Taylor; Vyshak Venur; Richard Ellenbogen; Andrew E Sloan; Kristin J Redmond; Matthew Foote; Samuel T Chao; John H Suh; Eric L Chang; Arjun Sahgal; Simon S Lo Journal: Curr Treat Options Oncol Date: 2021-06-07