Temporal evolution of perfusion parameters in brain metastases treated with stereotactic radiosurgery: comparison of

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Anish Kapadia1, Hatef Mehrabian2, John Conklin1

  • 1Department of Medical Imaging, Sunnybrook Health Sciences Centre and University of Toronto, 2075 Bayview Ave., Toronto, ON, M4N 3M5, Canada.

Journal of Neuro-Oncology
|July 3, 2017
PubMed

Insights

Intravoxel incoherent motion (IVIM) MRI and dynamic contrast-enhanced (DCE)-MRI show poor correlation for measuring brain tumor blood volume after stereotactic radiosurgery (SRS). IVIM measurements after SRS require cautious interpretation due to differing results compared to DCE-MRI.

Area of Science:

  • Neuro-oncology
  • Radiosurgery
  • Medical Imaging

Background:

  • Intravoxel incoherent motion (IVIM) MRI is increasingly used in neuro-oncology.
  • It offers an alternative to contrast-enhanced perfusion techniques for evaluating tumor blood volume post-stereotactic radiosurgery (SRS).
  • IVIM has not yet been validated against contrast-enhanced techniques for brain metastases after SRS.

Purpose of the Study:

  • To validate Intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) against dynamic contrast-enhanced (DCE)-MRI for measuring blood volume in brain metastases after stereotactic radiosurgery (SRS).

Main Methods:

  • Blood volume was measured in 20 brain metastases (15 patients) using both IVIM and DCE-MRI at baseline, 1 week, and 1 month post-SRS.
  • Correlation between IVIM and DCE-MRI blood volume measurements was analyzed.
  • Changes in tumor blood volume over time were assessed using both techniques.

Main Results:

  • Poor correlation was observed between IVIM and DCE-MRI for blood volume measurements at all time points (baseline, 1 week, 1 month).
  • No significant change in tumor blood volume was detected by either IVIM or DCE-MRI at 1 week post-SRS.
  • DCE-MRI showed a significant decrease in blood volume at 1 month, while IVIM showed a significant increase.

Conclusions:

  • Blood volume measurements obtained via IVIM and DCE-MRI are not equivalent for brain metastases treated with SRS.
  • The discrepancies may stem from differences in the perfusion information provided by each technique or limitations in IVIM's tumor blood volume measurements post-SRS.
  • IVIM measurements of tumor blood volume within a month after SRS should be interpreted with caution.
Keywords:
Brain metastasesDiffusion weighted magnetic resonance imagingDynamic contrast enhancedIntravoxel incoherent motionPerfusion magnetic resonance imagingStereotactic radiosurgery

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