Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
Physical Sciences, Sunnybrook Research Institute, M7-613, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
J Neurooncol. 2021 May;152(3):551-557. doi: 10.1007/s11060-021-03725-7. Epub 2021 Mar 19.
Stereotactic radiosurgery (SRS) is used to manage intracranial metastases in a significant fraction of patients. Local progression after SRS can often only be detected with increased volume of enhancement on serial MRI scans which may lag true progression by weeks or months.
Patients with intracranial metastases (N = 11) were scanned using hyperpolarized [Formula: see text]C MRI prior to treatment with stereotactic radiosurgery (SRS). The status of each lesion was then recorded at six months post-treatment follow-up (or at the time of death).
The positive predictive value of [Formula: see text]C-lactate signal, measured pre-treatment, for prediction of progression of intracranial metastases at six months post-treatment with SRS was 0.8 [Formula: see text], and the AUC from an ROC analysis was 0.77 [Formula: see text]. The distribution of [Formula: see text]C-lactate z-scores was different for intracranial metastases from different primary cancer types (F = 2.46, [Formula: see text]).
Hyperpolarized [Formula: see text]C imaging has potential as a method for improving outcomes for patients with intracranial metastases, by identifying patients at high risk of treatment failure with SRS and considering other therapeutic options such as surgery.
立体定向放射外科（SRS）用于治疗大量颅内转移瘤患者。SRS 后局部进展通常只能通过连续 MRI 扫描中增强体积的增加来检测，而这可能会延迟几周或几个月的真正进展。
在接受立体定向放射外科（SRS）治疗之前，对颅内转移瘤患者（N=11）进行了[Formula: see text]C 磁共振极化成像扫描。然后在治疗后 6 个月的随访（或死亡时）记录每个病变的状态。
治疗后 6 个月 SRS 预测颅内转移瘤进展的[Formula: see text]C-乳酸信号的阳性预测值为 0.8 [Formula: see text]，ROC 分析的 AUC 为 0.77 [Formula: see text]。来自不同原发性癌症类型的颅内转移瘤的[Formula: see text]C-乳酸 z 分数分布不同（F=2.46，[Formula: see text]）。
极化[Formula: see text]C 成像有可能通过识别 SRS 治疗失败风险较高的患者，并考虑其他治疗选择，如手术，从而改善颅内转移瘤患者的预后。
