Dynamic Contrast-Enhanced MRI in Patients with Brain Metastases Undergoing Laser Interstitial Thermal Therapy: A Pilot Study

Dynamic Contrast-Enhanced MRI in Patients with Brain Metastases Undergoing Laser Interstitial Thermal Therapy: A Pilot Study

Tumor recurrence is difficult to predict in patients receiving laser ablation for intracranial malignancy. We assessed the efficacy of the initial area under the time-to-signal intensity curve at 60 seconds (iAUC ) from dynamic contrast-enhanced MR imaging in predicting progression-free survival in...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR Vol. 40; no. 9; pp. 1451 - 1457
Main Authors: Traylor, J I, Bastos, D C A, Fuentes, D, Muir, M, Patel, R, Kumar, V A, Stafford, R J, Rao, G, Prabhu, S S
Format: Journal Article
Language:English
Published: United States American Society of Neuroradiology 01-09-2019
Subjects:
Adult Brain
Aged
Aged, 80 and over
Brain Neoplasms - diagnostic imaging
Brain Neoplasms - secondary
Brain Neoplasms - therapy
Cohort Studies
Contrast Media
Female
Functional
Humans
Image Processing, Computer-Assisted
Kaplan-Meier Estimate
Karnofsky Performance Status
Laser Therapy - methods
Magnetic Resonance Imaging - methods
Male
Middle Aged
Pilot Projects
Predictive Value of Tests
Progression-Free Survival
Prospective Studies
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Summary:Tumor recurrence is difficult to predict in patients receiving laser ablation for intracranial malignancy. We assessed the efficacy of the initial area under the time-to-signal intensity curve at 60 seconds (iAUC ) from dynamic contrast-enhanced MR imaging in predicting progression-free survival in patients with brain metastases following laser interstitial thermal therapy. The study population was a consecutive series of patients undergoing laser interstitial thermal therapy for brain metastases. Patient demographics including age, sex, tumor histology, and Karnofsky Performance Scale were collected prospectively. Preoperative, postoperative, and 1-month follow-up dynamic contrast-enhanced MRIs were analyzed. Values of iAUC were computed using a trapezoidal rule applied to the time history of contrast uptake over the first 60 seconds postenhancement. The change in iAUC (ΔiAUC ) was calculated by taking the difference between the values of iAUC from 2 time points. Pearson correlation coefficients were calculated between progression-free survival, defined as the time from laser interstitial thermal therapy to tumor recurrence, and iAUC or ΔiAUC values. Thirty-three cases of laser interstitial thermal therapy for 32 brain metastases in a cohort of 27 patients were prospectively analyzed. A significant relationship was observed between the values of iAUC from postoperative dynamic contrast-enhanced MR imaging and progression-free survival with Pearson correlation ( = .03) and Cox univariate analysis ( = .01). The relationship between preoperative and 1-month follow-up dynamic contrast-enhanced MR imaging was not significantly correlated with progression-free survival. Similarly, no statistically significant relationship was observed with ΔiAUC and progression-free survival between any time points. Progression-free survival is difficult to predict in patients undergoing laser interstitial thermal therapy for brain metastases due to confounding with posttreatment change. iAUC extracted from postoperative dynamic contrast-enhanced MR imaging shows promise for accurately prognosticating patients following this operative therapy.
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ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A6144