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Purpose <p>Stereotactic Radiosurgery (SRS) is an effective way of controlling the brain metastasis (BM) of lung carcinoma. This study evaluates the performance of dynamic contrast-enhanced MRI (DCE-MRI) and dynamic susceptibility contrast MRI (DSC-MRI) parameters to distinguish responders from non-responders at midterm follow-up in lung carcinoma BMs.</p> Methods <p>Twenty-six patients (mean age 62 ± 10 years) with 54 lung carcinoma BMs (NSCLC 67%, SCLC 33%) underwent SRS. The DCE-MRI and DSC-MRI were performed at baseline and repeated 4–8 weeks post-SRS to predict treatment responses at the midterm follow-up (6–12 months). Midterm outcomes were classified according to RANO-BM criteria as responders (complete response, partial response, or stable disease) or non-responders (progressive disease). Receiver operating characteristic (ROC) analyses evaluated the diagnostic accuracy of individual perfusion parameters and their combinations.</p> Results <p>Forty lesions (74%) were responders, while 14 (26%) were non-responders. Progressive lesions showed a mean volume increase of 5.5-fold, whereas responders demonstrated a 60% mean volume reduction. Responders showed significantly lower absolute post-SRS K-trans (median 0.015 vs. 0.035&#xa0;min⁻¹; <i>p</i> = 0.005), a higher proportional decrease in K-trans from baseline (− 27% vs. +13%; <i>p</i> = 0.017), and lower post-SRS Ve (<i>p</i> = 0.009) compared to non-responders. Absolute post-SRS K-trans had the highest individual predictive accuracy (AUC = 0.75, accuracy = 78%, sensitivity = 86%, specificity = 55%). Neither the dynamic change nor post-SRS nCBV alone predicted midterm response; however, combining post-SRS nCBV with K-trans slightly improved predictive performance (AUC = 0.76, accuracy = 79%).</p> Conclusion <p>Early post-SRS absolute K-trans is the best perfusion parameter for predicting midterm response in lung carcinoma BMs. DSC-MRI parameters alone offer limited predictive value.</p>

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Predictive value of early DCE and DSC perfusion MRI parameters for midterm clinical outcomes in lung cancer brain metastases treated with stereotactic radiosurgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月23日

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  • Yunus Emre Senturk,
  • Enes Muhammed Canturk,
  • Ahmet Peker,
  • Sabahattin Yüzkan,
  • Yavuz Samancı,
  • Selçuk Peker

摘要

Purpose

Stereotactic Radiosurgery (SRS) is an effective way of controlling the brain metastasis (BM) of lung carcinoma. This study evaluates the performance of dynamic contrast-enhanced MRI (DCE-MRI) and dynamic susceptibility contrast MRI (DSC-MRI) parameters to distinguish responders from non-responders at midterm follow-up in lung carcinoma BMs.

Methods

Twenty-six patients (mean age 62 ± 10 years) with 54 lung carcinoma BMs (NSCLC 67%, SCLC 33%) underwent SRS. The DCE-MRI and DSC-MRI were performed at baseline and repeated 4–8 weeks post-SRS to predict treatment responses at the midterm follow-up (6–12 months). Midterm outcomes were classified according to RANO-BM criteria as responders (complete response, partial response, or stable disease) or non-responders (progressive disease). Receiver operating characteristic (ROC) analyses evaluated the diagnostic accuracy of individual perfusion parameters and their combinations.

Results

Forty lesions (74%) were responders, while 14 (26%) were non-responders. Progressive lesions showed a mean volume increase of 5.5-fold, whereas responders demonstrated a 60% mean volume reduction. Responders showed significantly lower absolute post-SRS K-trans (median 0.015 vs. 0.035 min⁻¹; p = 0.005), a higher proportional decrease in K-trans from baseline (− 27% vs. +13%; p = 0.017), and lower post-SRS Ve (p = 0.009) compared to non-responders. Absolute post-SRS K-trans had the highest individual predictive accuracy (AUC = 0.75, accuracy = 78%, sensitivity = 86%, specificity = 55%). Neither the dynamic change nor post-SRS nCBV alone predicted midterm response; however, combining post-SRS nCBV with K-trans slightly improved predictive performance (AUC = 0.76, accuracy = 79%).

Conclusion

Early post-SRS absolute K-trans is the best perfusion parameter for predicting midterm response in lung carcinoma BMs. DSC-MRI parameters alone offer limited predictive value.