Fluid-Suppressed Amide Proton Transfer-Weighted Imaging Outperforms Leakage-Corrected Dynamic Susceptibility Contrast Perfusion in Distinguishing Progression from Radionecrosis in Brain Metastases

Cancers, Journal Year: 2025, Volume and Issue: 17(7), P. 1175 - 1175

Published: March 31, 2025

Background: Differentiating brain radionecrosis (RN) from tumor progression (TP) is a persistent clinical difficulty. Here, we compared the diagnostic accuracy of leakage-corrected relative cerebral blood volume (rCBV) and fluid-suppressed amide proton transfer-weighted (APTw) imaging in distinguishing between RN TP metastases. Methods: Subjects with enlarging lesions after stereotactic radiosurgery were prospectively examined at 3T. APTw data acquired 3D snapshot-gradient echo sequence. B0 B1 inhomogeneities corrected using WASAB1 protocol. rCBV was calculated according to established guidelines. Image analysis performed Olea Sphere 3.0 software. ΔAPTw ΔrCBV as average signal within lesion normalized against contralateral white matter. A diagnosis or assessed by histology follow-up. Independent samples t-tests areas under curve (AUCs) computed. Results: Twenty-one metastases (10 RN, 11 TP) evaluated. differentiated (U = 120, p < 0.001), contrast 71, 0.174). The AUC 0.991 (95% CI 0.962-1.020) for ΔAPTw, 0.636 0.352-0.921) ΔrCBV. optimal cutoff points 0.4 2.1 ΔrCBV, respectively. sensitivity specificity RN-TP 100% 90% 63.6% 36.4% Conclusions: Fluid-suppressed metrics enabled more accurate performances than TP. These promising results suggest that could valuably complement current multiparametric MRI protocols follow-ups.

Language: Английский

Repeat stereotactic radiosurgery for recurrent brain metastases: a retrospective comparison of local progression and distant brain metastases after prior radiosurgery

Journal of Neuro-Oncology, Journal Year: 2025, Volume and Issue: unknown

Published: April 9, 2025

Language: Английский