Martin A. Proescholdt , Tommaso Araceli , Karl-Michael Schebesch , Christian Doenitz , Christina Wendl , Katja Evert , Ekaterina Noeva , Julius Hoehne , Markus J. Riemenschneider , Daniela Hirsch , Nils Ole Schmidt , Daniela Sparrer , Florian Lüke , Daniel Heudobler , Tobias Pukrop , Raquel Blazquez
{"title":"MetInfilt: A prospective trial highlighting the importance of the histological growth pattern in brain metastases","authors":"Martin A. Proescholdt , Tommaso Araceli , Karl-Michael Schebesch , Christian Doenitz , Christina Wendl , Katja Evert , Ekaterina Noeva , Julius Hoehne , Markus J. Riemenschneider , Daniela Hirsch , Nils Ole Schmidt , Daniela Sparrer , Florian Lüke , Daniel Heudobler , Tobias Pukrop , Raquel Blazquez","doi":"10.1016/j.tranon.2025.102480","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>While the histological growth pattern (HGP) of liver metastases is frequently evaluated, the same attention is often absent for brain metastases despite evidence suggesting its prognostic significance. This oversight may stem from the lack of a standardized method for assessing the HGP at the macro-metastasis / brain parenchyma interface (MMPI<sub>brain</sub>). MetInfilt is the first prospective, imaging-guided trial aimed at standardizing the collection and analysis of the HGP at the MMPI<sub>brain</sub>.</div></div><div><h3>Methods</h3><div>We recruited fifty patients. The MMPI<sub>brain</sub> was identified using preoperative contrast-enhanced T1-weighted MRI. Intraoperative confocal microscopy (CONVIVO) visualized the MMPI<sub>brain</sub>, while a YELLOW 560 nm filter in the surgical microscope facilitated precise tissue sampling. Samples from the MMPI<sub>brain</sub> and the core of the metastasis were collected for postoperative histological confirmation.</div></div><div><h3>Results</h3><div>The protocol achieved successful tissue acquisition from the MMPI<sub>brain</sub> in 93.2 % of patients, meeting the study's primary endpoint. Preoperative MRI patterns strongly correlated with infiltrative HGPs, and CONVIVO accurately visualized the MMPI<sub>brain</sub> intraoperatively. Exploratory analyses suggest that infiltrative HGPs might negatively impact patient prognosis and represent a potential risk of meningeal metastasis.</div></div><div><h3>Conclusions</h3><div>Our neurosurgical protocol allows the successful and precise acquisition of tissue from the MMPI<sub>brain</sub> through presurgical imaging, intraoperative microscopy, and fluorescence-assisted sampling. The evaluation of the HGP in our limited patient cohort highlights its potential clinical significance and supports the urgent necessity to investigate it further for the benefit of patients with brain metastases.</div></div><div><h3>Clinical trial registration number</h3><div>Z-2019–1307–9.</div></div>","PeriodicalId":48975,"journal":{"name":"Translational Oncology","volume":"60 ","pages":"Article 102480"},"PeriodicalIF":5.0000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1936523325002116","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background
While the histological growth pattern (HGP) of liver metastases is frequently evaluated, the same attention is often absent for brain metastases despite evidence suggesting its prognostic significance. This oversight may stem from the lack of a standardized method for assessing the HGP at the macro-metastasis / brain parenchyma interface (MMPIbrain). MetInfilt is the first prospective, imaging-guided trial aimed at standardizing the collection and analysis of the HGP at the MMPIbrain.
Methods
We recruited fifty patients. The MMPIbrain was identified using preoperative contrast-enhanced T1-weighted MRI. Intraoperative confocal microscopy (CONVIVO) visualized the MMPIbrain, while a YELLOW 560 nm filter in the surgical microscope facilitated precise tissue sampling. Samples from the MMPIbrain and the core of the metastasis were collected for postoperative histological confirmation.
Results
The protocol achieved successful tissue acquisition from the MMPIbrain in 93.2 % of patients, meeting the study's primary endpoint. Preoperative MRI patterns strongly correlated with infiltrative HGPs, and CONVIVO accurately visualized the MMPIbrain intraoperatively. Exploratory analyses suggest that infiltrative HGPs might negatively impact patient prognosis and represent a potential risk of meningeal metastasis.
Conclusions
Our neurosurgical protocol allows the successful and precise acquisition of tissue from the MMPIbrain through presurgical imaging, intraoperative microscopy, and fluorescence-assisted sampling. The evaluation of the HGP in our limited patient cohort highlights its potential clinical significance and supports the urgent necessity to investigate it further for the benefit of patients with brain metastases.
期刊介绍:
Translational Oncology publishes the results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of oncology patients. Translational Oncology will publish laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer. Peer reviewed manuscript types include Original Reports, Reviews and Editorials.