Predictive value of early DCE and DSC perfusion MRI parameters for midterm clinical outcomes in lung cancer brain metastases treated with stereotactic radiosurgery.

IF 3.2 2区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuro-Oncology Pub Date : 2025-05-23 DOI:10.1007/s11060-025-05054-5

Yunus Emre Senturk, Enes Muhammed Canturk, Ahmet Peker, Sabahattin Yüzkan, Yavuz Samancı, Selçuk Peker

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引用次数: 0

Abstract

Purpose: Stereotactic Radiosurgery (SRS) is an effective way of controlling the brain metastasis (BM) of lung carcinoma. This study evaluates the performance of dynamic contrast-enhanced MRI (DCE-MRI) and dynamic susceptibility contrast MRI (DSC-MRI) parameters to distinguish responders from non-responders at midterm follow-up in lung carcinoma BMs.

Methods: Twenty-six patients (mean age 62 ± 10 years) with 54 lung carcinoma BMs (NSCLC 67%, SCLC 33%) underwent SRS. The DCE-MRI and DSC-MRI were performed at baseline and repeated 4-8 weeks post-SRS to predict treatment responses at the midterm follow-up (6-12 months). Midterm outcomes were classified according to RANO-BM criteria as responders (complete response, partial response, or stable disease) or non-responders (progressive disease). Receiver operating characteristic (ROC) analyses evaluated the diagnostic accuracy of individual perfusion parameters and their combinations.

Results: Forty lesions (74%) were responders, while 14 (26%) were non-responders. Progressive lesions showed a mean volume increase of 5.5-fold, whereas responders demonstrated a 60% mean volume reduction. Responders showed significantly lower absolute post-SRS K-trans (median 0.015 vs. 0.035 min⁻¹; p = 0.005), a higher proportional decrease in K-trans from baseline (- 27% vs. +13%; p = 0.017), and lower post-SRS Ve (p = 0.009) compared to non-responders. Absolute post-SRS K-trans had the highest individual predictive accuracy (AUC = 0.75, accuracy = 78%, sensitivity = 86%, specificity = 55%). Neither the dynamic change nor post-SRS nCBV alone predicted midterm response; however, combining post-SRS nCBV with K-trans slightly improved predictive performance (AUC = 0.76, accuracy = 79%).

Conclusion: Early post-SRS absolute K-trans is the best perfusion parameter for predicting midterm response in lung carcinoma BMs. DSC-MRI parameters alone offer limited predictive value.

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早期DCE和DSC灌注MRI参数对立体定向放射治疗肺癌脑转移中期临床结果的预测价值。

目的：立体定向放射外科治疗是控制肺癌脑转移的有效方法。本研究评估动态对比增强MRI （DCE-MRI）和动态敏感性对比MRI （DSC-MRI）参数在肺癌脑转移中期随访中的表现，以区分反应者和无反应者。方法：26例（平均年龄62±10岁）54例肺癌脑转移患者（NSCLC 67%, SCLC 33%）行SRS。DCE-MRI和DSC-MRI在基线进行，并在srs后4-8周重复进行，以预测中期随访（6-12个月）的治疗反应。中期结果根据RANO-BM标准分为反应（完全反应、部分反应或疾病稳定）或无反应（疾病进展）。受试者工作特征（ROC）分析评估单个灌注参数及其组合的诊断准确性。结果：40例（74%）病灶有反应，14例（26%）无反应。进行性病变显示平均体积增加5.5倍，而应答者显示平均体积减少60%。应答者的srs后K-trans绝对值显著降低（中位数0.015 vs 0.035分钟）；p = 0.005)， K-trans较基线下降的比例更高(- 27% vs +13%；p = 0.017)，与无反应者相比，srs后Ve更低（p = 0.009）。绝对srs后K-trans具有最高的个体预测准确度（AUC = 0.75，准确度= 78%，灵敏度= 86%，特异性= 55%）。动态变化和srs后nCBV均不能单独预测中期反应；然而，将srs后nCBV与K-trans相结合略微提高了预测性能（AUC = 0.76，准确率= 79%）。结论：srs后早期绝对K-trans是预测肺癌脑转移中期疗效的最佳灌注参数。仅DSC-MRI参数的预测价值有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuro-Oncology 医学-临床神经学

CiteScore

6.60

自引率

7.70%

发文量

277

审稿时长

3.3 months

期刊介绍： The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.