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Multisite Benchmark Study for Standardized Relative CBV in Untreated Brain Metastases Using the DSC-MRI Consensus

Sarah Kohn Loizzo1, Melissa A Prah2, Min J Kong3

  • 1From the Department of Radiation Oncology (S.K.L.), Medical College of Wisconsin, Milwaukee, Wisconsin.

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|October 10, 2024
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Summary
This summary is machine-generated.

This study established a benchmark for standardized relative cerebral blood volume (srCBV) in brain metastases using a national consensus DSC-MRI protocol. Results show lower srCBV in metastases compared to glioblastoma, aiding in diagnosis and treatment monitoring.

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Area of Science:

  • Neuroimaging
  • Oncology
  • Radiology

Background:

  • A national consensus protocol for DSC-MRI perfusion data collection was established to standardize relative cerebral blood volume (rCBV) measurements in brain tumors.
  • This aims to reduce intersite variability and facilitate comparisons across studies for brain metastases and primary brain tumors.

Purpose of the Study:

  • To prospectively collect consensus DSC-MRI data for brain metastases.
  • To characterize derived rCBV maps in untreated brain metastases.
  • To compare rCBV in brain metastases against glioblastoma (GBM) and normal-appearing brain using the consensus protocol.

Main Methods:

  • Multisite prospective study involving 49 patients with untreated brain metastases and 31 with GBM.
  • DSC-MRI data collected using a midrange flip angle, GRE-EPI acquisition, and a specific contrast agent protocol.
  • Quantitative standardized relative CBV (srCBV) maps generated; comparisons made with normal-appearing white matter (NAWM) and GBM using non-parametric statistical tests.

Main Results:

  • Mean srCBV for all brain metastases (1.83±1.05) was significantly lower than for GBM (2.67 ± 1.34) (P = .0009).
  • Both metastases and GBM showed significantly higher srCBV than NAWM (0.68 ± 0.18) (P < .0001).
  • Distinct metastases, including lung and genitourinary, showed statistically different srCBV compared to GBM.

Conclusions:

  • The consensus DSC-MRI protocol successfully determined mean srCBV values for treatment-naïve brain metastases.
  • These findings establish a benchmark for srCBV in brain metastases relative to NAWM and GBM.
  • This provides a standardized measure for future research adhering to the national consensus recommendation.