MENU ▼
Read by QxMD icon Read
search
OPEN IN READ APP
JOURNAL ARTICLE

A 3D quantitative imaging biomarker in pre-treatment MRI predicts overall survival after stereotactic radiation therapy of patients with a singular brain metastasis

Marta Della Seta, Federico Collettini, Julius Chapiro, Alexander Angelidis, Fidelis Engeling, Bernd Hamm, David Kaul
Acta Radiologica 2019 March 6, : 284185119831692
30841703

BACKGROUND: Brain metastases (BM) are the most frequent intracranial malignant tumor. Various prognostic factors facilitate the prediction of survival; however, few have become tools for clinical use.

PURPOSE: To investigate the role of three-dimensional (3D) quantitative tissue enhancement in pre-treatment cranial magnetic resonance imaging (MRI) as a radiomic biomarker for survival (OS) in patients with singular BM treated with stereotactic radiation therapy (SRT).

MATERIAL AND METHODS: In this retrospective study, 48 patients (27 non-small cell lung cancer and 21 melanoma) with singular BM treated with SRT, were analyzed. Contrast-enhanced MRI scans of the neurocranium were used for quantitative image analyses. Segmentation-based 3D quantification was performed to measure the enhancing tumor volume. A cut-off value of 68.61% of enhancing volume was used to stratify the cohort into two groups (≤68.61% and > 68.61%). Univariable and multivariable cox regressions were used to analyze the prognostic factors of OS and intracranial progression-free survival (iPFS).

RESULTS: The level of enhancing tumor volume achieved statistical significance in univariable and multivariable analysis for OS (univariable: P = 0.005, hazard ratio [HR] = 0.375, 95% confidence interval [CI] = 0.168-0.744; multivariable: P = 0.006, HR = 0.376, 95% CI = 0.186-0.757). Patients with high-level enhancement (>68.61% enhancing lesion volume) survived significantly longer (4.9 vs. 10.2 months) and showed significantly longer iPFS rates (univariable: P < 0.001, HR = 0.046, 95% CI = 0.009-0.245).

CONCLUSIONS: Patients with lesions that show a higher percentage of enhancement in pre-treatment MRI demonstrated improved iPFS and OS compared to those with mainly hypo-enhancing lesions. Lesion enhancement may be a radiomic marker, useful in prognostic indices for survival prediction, in patients with singular BM.

Comments

You need to log in or sign up for an account to be able to comment.

No comments yet, be the first to post one!

Trending on Read

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
30841703
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"