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Pathologic Correlation of Cellular Imaging Using Apparent Diffusion Coefficient Quantification in Patients with Brain
Hamid Borghei-Razavi1, Mayur Sharma1, Todd Emch2
1Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA; Rose Ella Burkhart Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio, USA.
World Neurosurgery
|November 17, 2019
Summary
Apparent diffusion coefficient (ADC) on MRI and initial tumor volume can help differentiate radiation necrosis from recurrent tumors after Gamma Knife radiosurgery for brain metastases.
Area of Science:
- Neuro-oncology
- Radiosurgery
- Medical Imaging
Background:
- Distinguishing radiation necrosis (RN) from recurrent tumor after Gamma Knife radiosurgery (GKRS) for brain metastases (BMs) is clinically significant.
- Accurate differentiation impacts treatment decisions and patient outcomes.
Purpose of the Study:
- To evaluate the utility of apparent diffusion coefficient (ADC) in differentiating RN from recurrent tumor post-GKRS for BMs.
- To assess the combined predictive value of ADC and initial lesion volume.
Main Methods:
- Retrospective analysis of 41 patients with BM undergoing surgical intervention post-GKRS.
- Calculation of ADC values from pre-resection MRI and correlation with pathological findings.
- Assessment of initial lesion volume as a predictor.
Main Results:
- ADC >1.5 × 10⁻³ mm²/s on pre-resection MRI predicted significant RN (P < 0.05).
- Larger initial target volumes (>10 cc) before GKRS were also associated with an elevated risk of RN (P < 0.05).
- Both ADC and initial target volume were significant predictors of RN.
Conclusions:
- Lesion ADC on MRI and initial target volume can predict radiation necrosis with reasonable accuracy.
- This combination aids in differentiating RN from recurrent tumor after GKRS for BMs.
