1
|
Thrower SL, Al Feghali KA, Luo D, Paddick I, Hou P, Briere T, Li J, McAleer MF, McGovern SL, Woodhouse KD, Yeboa DN, Brock KK, Chung C. The Effect of Slice Thickness on Contours of Brain Metastases for Stereotactic Radiosurgery. Adv Radiat Oncol 2021; 6:100708. [PMID: 34124413 PMCID: PMC8175282 DOI: 10.1016/j.adro.2021.100708] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/22/2021] [Accepted: 04/06/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Stereotactic radiosurgery is a common treatment for brain metastases and is typically planned on magnetic resonance imaging (MRI). However, the MR acquisition parameters used for patient selection and treatment planning for stereotactic radiosurgery can vary within and across institutions. In this work, we investigate the effect of MRI slice thickness on the detection and contoured volume of metastatic lesions in the brain. METHODS AND MATERIALS A retrospective cohort of 28 images acquired with a slice thickness of 1 mm were resampled to simulate acquisitions at 2- and 3-mm slice thickness. A total of 102 metastases ranging from 0.0030 cc to 5.08 cc (75-percentile 0.36 cc) were contoured on the original images. All 3 sets of images were recontoured by experienced physicians. RESULTS Of all the images detected and contoured on the 1 mm images, 3% of lesions were missed on the 2 mm images, and 13% were missed on the 3 mm images. One lesion that was identified on both the 2 mm and 3 mm images was determined to be a blood vessel on the 1 mm images. Additionally, the lesions were contoured 11% larger on the 2 mm and 43% larger on the 3 mm images. CONCLUSIONS Using images with a slice thickness >1 mm effects detection and segmentation of brain lesions, which can have an important effect on patient management and treatment outcomes.
Collapse
Affiliation(s)
- Sara L. Thrower
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Karine A. Al Feghali
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dershan Luo
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ian Paddick
- Queen Square Radiosurgery Centre, National Hospital for Neurology and Neurosurgery, London, England
| | - Ping Hou
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tina Briere
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jing Li
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mary Frances McAleer
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan L. McGovern
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kristina Demas Woodhouse
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Debra Nana Yeboa
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kristy K. Brock
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Caroline Chung
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
2
|
Moravan MJ, Fecci PE, Anders CK, Clarke JM, Salama AKS, Adamson JD, Floyd SR, Torok JA, Salama JK, Sampson JH, Sperduto PW, Kirkpatrick JP. Current multidisciplinary management of brain metastases. Cancer 2020; 126:1390-1406. [PMID: 31971613 DOI: 10.1002/cncr.32714] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/08/2019] [Accepted: 12/19/2019] [Indexed: 12/31/2022]
Abstract
Brain metastasis (BM), the most common adult brain tumor, develops in 20% to 40% of patients with late-stage cancer and traditionally are associated with a poor prognosis. The management of patients with BM has become increasingly complex because of new and emerging systemic therapies and advancements in radiation oncology and neurosurgery. Current therapies include stereotactic radiosurgery, whole-brain radiation therapy, surgical resection, laser-interstitial thermal therapy, systemic cytotoxic chemotherapy, targeted agents, and immune-checkpoint inhibitors. Determining the optimal treatment for a specific patient has become increasingly individualized, emphasizing the need for multidisciplinary discussions of patients with BM. Recognizing and addressing the sequelae of BMs and their treatment while maintaining quality of life and neurocognition is especially important because survival for patients with BMs has improved. The authors present current and emerging treatment options for patients with BM and suggest approaches for managing sequelae and disease recurrence.
Collapse
Affiliation(s)
- Michael J Moravan
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.,Department of Radiation Oncology, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Peter E Fecci
- Department of Neurosurgery, Duke University Hospital, Durham, North Carolina
| | - Carey K Anders
- Department of Internal Medicine, Division of Medical Oncology, Duke University Hospital, Durham, North Carolina
| | - Jeffrey M Clarke
- Department of Internal Medicine, Division of Medical Oncology, Duke University Hospital, Durham, North Carolina
| | - April K S Salama
- Department of Internal Medicine, Division of Medical Oncology, Duke University Hospital, Durham, North Carolina
| | - Justus D Adamson
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Scott R Floyd
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Jordan A Torok
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Joseph K Salama
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.,Department of Radiation Oncology, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - John H Sampson
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.,Department of Neurosurgery, Duke University Hospital, Durham, North Carolina
| | - Paul W Sperduto
- Minneapolis Radiation Oncology, Minneapolis, Minnesota.,University of Minnesota Gamma Knife Center, Minneapolis, Minnesota
| | - John P Kirkpatrick
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.,Department of Neurosurgery, Duke University Hospital, Durham, North Carolina
| |
Collapse
|