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Open Access 17-08-2022 | Cerebral Metastase | Original Article

Stereotactic radiotherapy of brain metastases: clinical impact of three-dimensional SPACE imaging for 3T-MRI-based treatment planning

Authors: Thomas Welzel, MD, Rami A. El Shafie, MD, Bastian v. Nettelbladt, Denise Bernhardt, MD, Stefan Rieken, MD, Jürgen Debus, MD PhD

Published in: Strahlentherapie und Onkologie | Issue 10/2022

Abstract

Purpose

For planning CyberKnife stereotactic radiosurgery (CK SRS) of brain metastases (BM), it is essential to precisely determine the exact number and location of BM in MRI. Recent MR studies suggest the superiority of contrast-enhanced 3D fast spin echo SPACE (sampling perfection with application-optimized contrast by using different flip angle evolutions) images over 3D gradient echo (GE) T1-weighted MPRAGE (magnetization-prepared rapid gradient echo) images for detecting small BM. The aim of this study is to test the usability of the SPACE sequence for MRI-based radiation treatment planning and its impact on changing treatment.

Methods

For MRI-based radiation treatment planning using 3T MRI in 199 patients with cerebral oligometastases, we compared the detectability of BM in post-gadolinium SPACE images, post-gadolinium MPRAGE images, and post-gadolinium late-phase MPRAGE images.

Results

When SPACE images were used for MRI-based radiation treatment planning, 29.8% and 16.9% more BM, respectively, were detected and included in treatment planning than in the post-gadolinium MPRAGE images and the post-gadolinium late-phase MPRAGE images (post-gadolinium MPRAGE imaging: n_total = 681, mean ± SD 3.4 ± 4.2; post-gadolinium SPACE imaging: n_total = 884, mean ± SD 4.4 ± 6.0; post-gadolinium late-phase MPRAGE imaging: n_total = 796, mean ± SD 4.0 ± 5.3; P_{post-gadolinium SPACE imaging versus post-gadolinium MPRAGE imaging} < 0.0001, P_{post-gadolinium SPACE imaging versus post-gadolinium late-phase MPRAGE imaging}< 0.0001).

Conclusion

For 3T MRI-based treatment planning of stereotactic radiosurgery of BM, we recommend the use of post-gadolinium SPACE imaging rather than post-gadolinium MPRAGE imaging.

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Title: Stereotactic radiotherapy of brain metastases: clinical impact of three-dimensional SPACE imaging for 3T-MRI-based treatment planning
Authors: Thomas Welzel, MD
Rami A. El Shafie, MD
Bastian v. Nettelbladt
Denise Bernhardt, MD
Stefan Rieken, MD
Jürgen Debus, MD PhD
Publication date: 17-08-2022
Publisher: Springer Berlin Heidelberg
Keywords: Cerebral Metastase
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Metastasis
Radiation Treatment Planning
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 10/2022
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-022-01996-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Stereotactic radiotherapy of brain metastases: clinical impact of three-dimensional SPACE imaging for 3T-MRI-based treatment planning

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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