Alison L Salkeld1, Eric K C Hau2, Najmun Nahar3, Jonathan R Sykes4, Wei Wang2, David I Thwaites5. 1. Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Hawksbury Road, Westmead, Australia; Institute of Medical Physics, The University of Sydney, New South Wales, Australia; Sydney West Radiation Oncology Network, Sydney, Australia; Sydney West Translational Cancer Research Centre, Hawksbury Road, Westmead, Australia; School of Medicine, The University of Sydney, New South Wales, Australia. Electronic address: asal5592@uni.sydney.edu.au. 2. Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Hawksbury Road, Westmead, Australia; Sydney West Radiation Oncology Network, Sydney, Australia; Sydney West Translational Cancer Research Centre, Hawksbury Road, Westmead, Australia; School of Medicine, The University of Sydney, New South Wales, Australia. 3. Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Hawksbury Road, Westmead, Australia; Sydney West Radiation Oncology Network, Sydney, Australia. 4. Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Hawksbury Road, Westmead, Australia; Institute of Medical Physics, The University of Sydney, New South Wales, Australia; Sydney West Radiation Oncology Network, Sydney, Australia; Sydney West Translational Cancer Research Centre, Hawksbury Road, Westmead, Australia. 5. Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Hawksbury Road, Westmead, Australia; Sydney West Radiation Oncology Network, Sydney, Australia; Sydney West Translational Cancer Research Centre, Hawksbury Road, Westmead, Australia; School of Physics, The University of Sydney, New South Wales, Australia.
Abstract
PURPOSE: To determine whether there are any changes in brain metastases or resection cavity volumes between planning magnetic resonance imaging (MRI) and radiosurgery (RS) treatment and whether these led to a change in management or alteration in the RS plan. METHODS AND MATERIALS: Patients undergoing RS for brain metastasis or tumor resection cavities had a standardized planning MRI (MRI-1) performed and a repeat verification MRI (MRI-2) 24 hours before RS. Any change in management, including replanning based on MRI-2, was recorded. RESULTS: Thirty-four patients with a total of 59 lesions (44 metastases and 15 tumor resection cavities) were assessed with a median time between MRI-1 and MRI-2 of 7 days. Seventeen patients (50%) required a change in management based on the changes seen on MRI-2. For patients with 7 days or less between scans, 41% (9 of 22) required a change in management; among patients with 8 days or more between scans, 78% (7 of 9) required a change in management. Per lesion, 32 out of 59 lesions required replanning, including 7 of 15 (47%) cavities and 25 of 44 (57%) metastases, with the most common reason (23 lesions) being an increase in gross target volume (tumor) or clinical target volume (tumor cavity). CONCLUSIONS: Measurable changes occur in brain metastasis over a short amount of time, with a change in management required in 41% of patients with 7 days between MRI-1 and MRI-2 and in 78% of patients when there is a delay longer than 7 days. We therefore recommend that the time between planning MRI and RS treatment be as short as possible.
PURPOSE: To determine whether there are any changes in brain metastases or resection cavity volumes between planning magnetic resonance imaging (MRI) and radiosurgery (RS) treatment and whether these led to a change in management or alteration in the RS plan. METHODS AND MATERIALS: Patients undergoing RS for brain metastasis or tumor resection cavities had a standardized planning MRI (MRI-1) performed and a repeat verification MRI (MRI-2) 24 hours before RS. Any change in management, including replanning based on MRI-2, was recorded. RESULTS: Thirty-four patients with a total of 59 lesions (44 metastases and 15 tumor resection cavities) were assessed with a median time between MRI-1 and MRI-2 of 7 days. Seventeen patients (50%) required a change in management based on the changes seen on MRI-2. For patients with 7 days or less between scans, 41% (9 of 22) required a change in management; among patients with 8 days or more between scans, 78% (7 of 9) required a change in management. Per lesion, 32 out of 59 lesions required replanning, including 7 of 15 (47%) cavities and 25 of 44 (57%) metastases, with the most common reason (23 lesions) being an increase in gross target volume (tumor) or clinical target volume (tumor cavity). CONCLUSIONS: Measurable changes occur in brain metastasis over a short amount of time, with a change in management required in 41% of patients with 7 days between MRI-1 and MRI-2 and in 78% of patients when there is a delay longer than 7 days. We therefore recommend that the time between planning MRI and RS treatment be as short as possible.
Authors: Tugce Kutuk; Ranjini Tolakanahalli; Andre Williams; Martin C Tom; Jason D Vadhan; Haley Appel; Matthew D Hall; D Jay J Wieczorek; Stephen Davis; Michael W McDermott; Manmeet S Ahluwalia; Minesh P Mehta; Alonso N Gutierrez; Rupesh Kotecha Journal: Neurooncol Pract Date: 2021-07-28
Authors: Danilo Maziero; Michael W Straza; John C Ford; Joseph A Bovi; Tejan Diwanji; Radka Stoyanova; Eric S Paulson; Eric A Mellon Journal: Front Oncol Date: 2021-03-08 Impact factor: 6.244