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Updated: Dec 29, 2025
Modeling Brain Metastases Through Intracranial Injection and Magnetic Resonance Imaging
Published on: June 7, 2020
Predicting intracranial progression following stereotactic radiosurgery for brain metastases: Implications for post
Brahma D Natarajan1, Christel N Rushing2, Michael A Cummings3
1Department of Radiation Oncology, Duke University, Durham, NC, USA.
Purpose:
Follow-up imaging after stereotactic radiosurgery (SRS) is crucial to identify salvageable brain metastases (BM) recurrence. As optimal imaging intervals are poorly understood, we sought to build a predictive model for time to intracranial progression.
Methods:
Consecutive patients treated with SRS for BM at three institutions from January 1, 2002 to June 30, 2017 were retrospectively reviewed. We developed a model using stepwise regression that identified four prognostic factors and built a predictive nomogram.
Results:
We identified 755 patients with primarily non-small cell lung, breast, and melanoma BMs. Factors such as number of BMs, histology, history of prior whole-brain radiation, and time interval from initial cancer diagnosis to metastases were prognostic for intracranial progression. Per our nomogram, risk of intracranial progression by 3 months post-SRS in the high-risk group was 21% compared to 11% in the low-risk group; at 6 months, it was 43% versus 27%.
Conclusion:
We present a nomogram estimating time to BM progression following SRS to potentially personalize surveillance imaging.
