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Investigation of Dose-Correlated MR Biomarker Changes in Brain Metastases Post-SRS

J Winter1*, F Moraes1 , C Chung2 , C Coolens1 , (1) Princess Margaret Cancer Center, Toronto, Ontario, (2) The University of Texas MD Anderson Cancer Center, Houston, Texas


(Wednesday, 8/1/2018) 7:30 AM - 9:30 AM

Room: Karl Dean Ballroom C

Purpose: To develop a framework for assessing voxel-wise dose-correlated changes in key magnetic resonance (MR) biomarkers and apply this framework to a cohort of patients with brain metastases (BM) treated with stereotactic radiosurgery (SRS). Specifically, we investigated apparent diffusion coefficient (ADC) and dynamic contrast-enhanced (DCE) MRI parameters within a common coordinate system with dose and contours.

Methods: To enable spatially-registered voxel-wise analyses with dose, we created a registration pipeline to perform image registration steps and visualize registration results using Python interacting with 3D Slicer. We also employed an in-house-developed 4-D temporal dynamic analysis approach to extract the contrast transfer coefficient (Ktrans) and volume of extracellular extravascular space (ve) from dynamic DCE-MRI time courses. For our clinical study, we processed prospective MRI data collected from 18 patients (29 BM, 5 with imaging-diagnosed radionecrosis) at day 0, 3 and 20 following 15–21 Gy SRS. For each voxel, we computed ΔADC, ΔKtrans and Δve for day 3 and 20 post-SRS relative to day 0 both within the GTV and the surrounding >12 Gy dose level. We performed linear regression analyses for ΔMR biomarker versus dose at day 3 and 20.

Results: Across all subjects, we observed significant negative correlations between ΔKtrans and Δve with dose at day 20 within the GTV and >12 Gy region (r = -0.04 to -0.16, p<0.001). In contrast, for radionecrotic BMs we found significant positive dose-correlated ΔADC increases only in the GTV (r = 0.11 to 0.19, p<0.001).

Conclusion: We provide a framework for investigating voxel-wise MR biomarker changes that may aid delineation of local control, subclinical normal brain injury and radionecrosis. Our results demonstrated weak but significant dose-correlated reductions in Ktrans and ve at 20 days following SRS both within the GTV and the surrounding >12 Gy region, an indication of radiation-induced vascular changes.


MRI, Stereotactic Radiosurgery, Registration


TH- response assessment : MR imaging-based

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