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Modeling Brain Metastases Through Intracranial Injection and Magnetic Resonance Imaging
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Volumetric analysis: Rethinking brain metastases response assessment.

Beatriz Ocaña-Tienda1, Julián Pérez-Beteta1, José Antonio Romero-Rosales1

  • 1Mathematical Oncology Laboratory, University of Castilla-La Mancha, Ciudad Real, Spain.

Neuro-Oncology Advances
|January 8, 2024
PubMed
Summary

Volumetric measurements improve brain metastases (BMs) response assessment over RANO-BM criteria. This new method evaluates all lesions, classifies responses better, and detects recurrence earlier for neuro-oncology patients.

Keywords:
MRIbrain metastasesprogressive diseasestereotactic radiosurgeryvolumetric analysis

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Area of Science:

  • Neuro-oncology
  • Radiology
  • Medical imaging analysis

Background:

  • The Response Assessment in Neuro-Oncology for Brain Metastases (RANO-BM) criteria are standard for evaluating brain metastases (BMs) treatment response.
  • Current RANO-BM criteria rely on 1D measurements, despite high-resolution 3D MRI scans being routinely used for BMs.
  • This limitation highlights the need for improved assessment methods that can leverage 3D imaging data.

Purpose of the Study:

  • To investigate the efficacy of volumetric measurements in enhancing the assessment of treatment response in patients with brain metastases.
  • To compare the performance of volumetric criteria against the established RANO-BM criteria.

Main Methods:

  • Retrospective analysis of 783 brain metastases (BMs) from 132 patients treated with stereotactic radiotherapy.
  • Utilized T1-weighted MRI scans to calculate lesion volumes.
  • Defined progressive disease as a ≥30% volume increase and partial response as a 20% volume reduction for volumetric criteria.

Main Results:

  • Volumetric criteria evaluated all lesions, unlike RANO-BM which missed 9.2%.
  • Effectively classified response in 140 lesions compared to 72 by RANO-BM.
  • Identified BM recurrences a median of 3.3 months earlier than RANO-BM.

Conclusions:

  • Volumetric criteria demonstrate superiority over RANO-BM for assessing brain metastases treatment response.
  • Proposed volumetric criteria offer a standardized, reliable, and objective tool for evaluating all lesions, improving classification, and enabling earlier detection of disease progression.