A 3D quantitative imaging biomarker in pre-treatment MRI predicts overall survival after stereotactic radiation therapy of patients with a singular brain metastasis
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-tre...
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Veröffentlicht in: | Acta radiologica (1987) 2019-11, Vol.60 (11), p.1496-1503 |
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Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | 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 |
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ISSN: | 0284-1851 1600-0455 |
DOI: | 10.1177/0284185119831692 |