Importance of 3D-TSE imaging for patients with brain metastasis treated with SRS alone

This study evaluates the clinical utility of 3D turbo spin echo (3D-TSE) imaging in stereotactic radiosurgery (SRS) planning for brain metastases, examining the value of adding 3D-TSE to MPRAGE. Dual-sequence MRI (MPRAGE + 3D-TSE) significantly prolonged time to distant intracranial failure (DIF) in whole brain radiotherapy (WBRT)-naïve patients (n = 308, 11.4 vs. 6.8 months, p = 0.03), but not in patients previously treated with WBRT and salvaged with SRS (n = 39, 6.5 vs. 5.6 months, p = 0.76). Additional lesion detection attributed to 3D-TSE imaging was greater in WBRT-naïve (19.6 %) than in post-WBRT patients (12.0 %) (p < 0.001). The dual-sequence imaging may improve time to distant failure in the modern era for most patients treated with primary stereotactic radiosurgery and should be integrated into the SRS workflow.