Sawlani, V, Davies, N, Patel, M, Flintham, R, Fong, C, Heyes, G, Cruickshank, G, Steven, N, Peet, A, Hartley, A, Benghiat, H, Meade, S and Sanghera, P (2019) Evaluation of Response to Stereotactic Radiosurgery in Brain Metastases Using Multiparametric Magnetic Resonance Imaging and a Review of the Literature. Clinical oncology (Royal College of Radiologists (Great Britain)), 31 (1). pp. 41-49. ISSN 1433-2981. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Full text not available from this repository.Abstract
AIMS
Following stereotactic radiosurgery (SRS), brain metastases initially increase in size in up to a third of cases, suggesting treatment failure. Current imaging using structural magnetic resonance imaging (MRI) cannot differentiate between tumour recurrence and SRS-induced changes, creating difficulties with patient management. Combining multiparametric MRI techniques, which assess tissue physiological and metabolic information, has shown promise in answering this clinical question.
MATERIALS AND METHODS
Multiparametric MRI techniques, including spectroscopy, diffusion and perfusion imaging, were used for the differentiation of radiation-related changes and tumour recurrence after SRS for intracranial metastases in six cases. All patients presented with enlargement of the treated lesion, an increase in perilesional brain oedema and aggravation or appearance of neurological signs and symptoms from 7 to 29 weeks after primary treatment.
RESULTS
Multiparametric imaging helped to differentiate features of tumour progression (n = 4) from radiation-related changes (n = 2). A low apparent diffusion coefficient (ADC) <1000 × 10 mm/s, high relative cerebral blood volume (rCBV) ratio > 2.1, high choline:creatine (Cho:Cr) ratio > 1.8 suggested tumour recurrence. A high ADC > 1000 × 10 mm/s, low rCBV ratio < 2.1, Cho:Cr ratio < 1.8 suggested SRS-induced radiation changes. Multiparametric MRI diagnosis was confirmed by histology or radiological and clinical follow-up.
CONCLUSION
Multiparametric MRI was helpful in the early identification of radiation-related changes and tumour recurrence and may be useful for monitoring treatment changes in intracranial neoplasms after SRS treatment.
Item Type: | Article |
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Additional Information: | This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs |
Subjects: | QZ Pathology. Oncology WL Nervous system. Neurology WN Medical imaging. Radiology WO Surgery |
Divisions: | Planned IP Care > Oncology and Clinical Haematology |
Related URLs: | |
Depositing User: | Jamie Edgar |
Date Deposited: | 20 Dec 2019 14:17 |
Last Modified: | 20 Dec 2019 14:17 |
URI: | http://www.repository.uhblibrary.co.uk/id/eprint/2703 |
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