Magnetic resonance imaging evaluation of treatment efficacy and prognosis for brain metastases in lung cancer patients after radiotherapy: A preliminary study

Abstract

BackgroundThis study used magnetic resonance imaging (MRI) to monitor changes to brain metastases and investigate the imaging signs used to evaluate treatment efficacy and determine prognosis following radiotherapy for brain metastases from lung cancer.MethodsA total of 60 non‐small cell lung cancer patients with brain oligometastases were selected. MRI scans were conducted before and 3, 6, 9, 12, 18, 24, and 30 months after radiotherapy. The tumor and peritumoral edema diameters, Cho/Cr values, elevation of the Lip peak value, and whether the island (yu‐yuan) sign or high‐signal ring were present on T2 fluid‐attenuated inversion recovery (FLAIR) imaging were recorded for each metastasis.ResultsThe mortality risk was higher the earlier the maximum value of peritumoral edema diameter was reached, when there were fewer island signs, and when brain metastases did not present as tumor progression on imaging. There were significant differences in the average peritumoral edema diameter, apparent diffusion coefficient value, the number of elevated Lip peak values, and the number of T2 FLAIR imaging high‐signal rings in a year after radiotherapy in 14 patients with a survival period < 1 year compared to patients with a survival period > 2 years.ConclusionAfter radiotherapy for brain metastases, patients with the island sign had longer survival periods, high‐signal rings in T2 FLAIR, elevated Lip peaks, and reduced apparent diffusion coefficient values, indicating tumor necrosis. Increased diameter of metastases and Cho/Cr > 2 cannot serve as reliable indicators of brain metastasis progression.

Intravoxel Incoherent Motion Diffusion‐Weighted Imaging for Predicting and Monitoring the Response of Anti‐Angiogenic Treatment in the Orthotopic Nude Mouse Model of Lung Adenocarcinoma

“…Studies have shown that ADC values can be increased after radiotherapy and chemotherapy. 26,27 However, in addition to cell density, ADC values are also affected by many factors, such as blood flow and perfusion. 28 Orton et al suggested that anti-VEGF therapies mediate apoptosis and necrosis in tumor cells which lead to decreased cell density and increased ADC value.…”

Metastatic meningeal carcinomatosis from lung cancer: Report of a rare case

“…According to study by Liu et al, there is no gold standard for diagnosing meningeal carcinomatosis, and no obvious specificity for the diagnosis of meningeal carcinomatosis by MRI. 8 However, in our report, the abnormal enhancement of the meninges on contrast-enhanced scanning was used as an important index for assisting with a diagnosis of meningeal carcinomatosis.…”

Brain Metastases of Non-Small Cell Lung Cancer: Magnetic Resonance Spectroscopy for Clinical Outcome Assessment in Patients with Stereotactic Radiotherapy

“…A study of eighty-five cancer patients with brain metastases demonstrated that a decrease in the Cho/Cr ratio likely reflects an inhibition of proliferative activity and early apoptotic cell death ( P <0.001). 33 Despite the positive trends observed, recent work of Liu et al 34 showed that Cho/Cr >2 is not significantly correlated with mortality from brain metastases in lung cancer patients after radiotherapy. Can MRS accurately evaluate survival and tumor progression after radiotherapy for BM in NSCLC patients?…”