Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Dec 28, 2016; 8(12): 916-921
Published online Dec 28, 2016. doi: 10.4329/wjr.v8.i12.916
Value of serial magnetic resonance imaging in the assessment of brain metastases volume control during stereotactic radiosurgery
Gianvincenzo Sparacia, Francesco Agnello, Aurelia Banco, Francesco Bencivinni, Andrea Anastasi, Giovanna Giordano, Adele Taibbi, Massimo Galia, Tommaso Vincenzo Bartolotta
Gianvincenzo Sparacia, Francesco Agnello, Aurelia Banco, Francesco Bencivinni, Andrea Anastasi, Giovanna Giordano, Adele Taibbi, Massimo Galia, Tommaso Vincenzo Bartolotta, Department of Radiology, University of Palermo, 90127 Palermo, Italy
Author contributions: Sparacia G is the guarantor of integrity of entire study, study design, statistical analysis, analysis and interpretation of data, text editing, and literature research; Agnello F contributed to imaging data collecting, drafting the article, and literature research; Banco A and Bencivinni F contributed to MR images evaluation; Anastasi A, Girodano G, Taibbi A and Galia M contributed to clinical data collecting; Bartolotta TV contributed to text editing and critical revisions.
Institutional review board statement: This was a retrospective study approved by the Institutional Review Board of the University of Palermo, Department of Radiology - Palermo, Italy.
Informed consent statement: All patients had given written consent for this retrospective study.
Conflict-of-interest statement: All authors have no conflict-of-interest.
Data sharing statement: Participants gave informed consent for data sharing and the presented data are anonymized to avoid the risk of identification. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gianvincenzo Sparacia, MD, Department of Radiology, University of Palermo, Via del Vespro, 127, 90127 Palermo, Italy. sparacia@yahoo.com
Telephone: +39-091-6552385 Fax: +39-091-6552302
Received: May 30, 2016
Peer-review started: June 3, 2016
First decision: July 5, 2016
Revised: September 29, 2016
Accepted: October 17, 2016
Article in press: October 18, 2016
Published online: December 28, 2016
Processing time: 202 Days and 19.3 Hours
Abstract
AIM

To evaluate brain metastases volume control capabilities of stereotactic radiosurgery (SRS) through serial magnetic resonance (MR) imaging follow-up.

METHODS

MR examinations of 54 brain metastases in 31 patients before and after SRS were reviewed. Patients were included in this study if they had a pre-treatment MR examination and serial follow-up MR examinations at 6 wk, 9 wk, 12 wk, and 12 mo after SRS. The metastasis volume change was categorized at each follow-up as increased (> 20% of the initial volume), stable (± 20% of the initial volume) or decreased (< 20% of the initial volume).

RESULTS

A local tumor control with a significant (P < 0.05) volume decrease was observed in 25 metastases at 6-wk follow-up. Not significant volume change was observed in 23 metastases and a significant volume increase was observed in 6 metastases. At 9-wk follow-up, 15 out of 25 metastases that decreased in size at 6 wk had a transient tumor volume increase, followed by tumor regression at 12 wk. At 12-wk follow-up there was a significant reduction in volume in 45 metastases, and a significant volume increase in 4 metastases. At 12-mo follow-up, 19 metastases increased significantly in size (up to 41% of the initial volume). Volume tumor reduction was correlated to histopathologic subtype.

CONCLUSION

SRS provided an effective local brain metastases volume control that was demonstrated at follow-up MR imaging.

Keywords: Brain metastases; Stereotactic radiosurgery; Magnetic resonance imaging; Pseudo-progression; Radiation therapy

Core tip: Stereotactic radiosurgery (SRS) provided an effective long-term local volume control of brain metastases during 12-mo magnetic resonance (MR) imaging follow-up. A significant reduction of the tumor volume by 6 wk post-SRS was associated with long-term volume control suggesting that the timing for MR imaging follow-up at 6 wk, 9 wk, 12 wk and 12 mo after SRS, could be considered the most effective to provide useful information to make the best treatment decisions.