Mathematical Oncology Laboratory (MOLAB), University of Castilla-La Mancha, Ciudad Real, Spain.
Sanchinarro University Hospital, HM Hospitales, Madrid, Spain.
Cancer Imaging. 2024 Aug 20;24(1):111. doi: 10.1186/s40644-024-00753-0.
Stereotactic radiotherapy is the preferred treatment for managing patients with fewer than five brain metastases (BMs). However, some lesions recur after irradiation. The purpose of this study was to identify patients who are at a higher risk of failure, which can help in adjusting treatments and preventing recurrence.
In this retrospective multicenter study, we analyzed the predictive significance of a set of interpretable morphological features derived from contrast-enhanced (CE) T1-weighted MR images as imaging biomarkers using Kaplan-Meier analysis. The feature sets studied included the total and necrotic volumes, the surface regularity and the CE rim width. Additionally, we evaluated other nonmorphological variables and performed multivariate Cox analysis.
A total of 183 lesions in 128 patients were included (median age 61 [31-95], 64 men and 64 women) treated with stereotactic radiotherapy (57% single fraction, 43% fractionated radiotherapy). None of the studied variables measured at diagnosis were found to have prognostic value. However, the total and necrotic volumes and the CE rim width measured at the first follow-up after treatment and the change in volume due to irradiation can be used as imaging biomarkers for recurrence. The optimal classification was achieved by combining the changes in tumor volume before and after treatment with the presence or absence of necrosis (p < < 0.001).
This study demonstrated the prognostic significance of interpretable morphological features extracted from routine clinical MR images following irradiation in brain metastases, offering valuable insights for personalized treatment strategies.
立体定向放疗是管理少于 5 个脑转移瘤（BMs）患者的首选治疗方法。然而，一些病灶在照射后会复发。本研究的目的是确定复发风险较高的患者，这有助于调整治疗方案，预防复发。
在这项回顾性多中心研究中，我们使用 Kaplan-Meier 分析，分析了从增强（CE）T1 加权 MR 图像中提取的一组可解释形态特征作为成像生物标志物的预测意义。所研究的特征集包括总坏死体积、表面规则性和 CE 边缘宽度。此外，我们还评估了其他非形态学变量，并进行了多变量 Cox 分析。
共纳入 128 例 183 个病灶患者（中位年龄 61 [31-95]，64 名男性和 64 名女性），接受立体定向放疗（57%单次分割，43%分割放疗）。在诊断时测量的所有研究变量均未发现具有预后价值。然而，治疗后第一次随访时测量的总坏死体积和 CE 边缘宽度以及因照射引起的体积变化可作为复发的成像生物标志物。通过结合治疗前后肿瘤体积的变化与坏死的存在与否，可实现最佳分类（p<0.001）。
本研究表明，从脑转移瘤照射后常规临床 MR 图像中提取的可解释形态特征具有预后意义，为个性化治疗策略提供了有价值的见解。
