NEW research has identified specific imaging biomarkers that can help predict the risk of recurrence in patients with brain metastases (BM) treated with stereotactic radiotherapy, the preferred treatment for managing patients with fewer than five BMs. This discovery could lead to more personalised treatment strategies to reduce the likelihood of tumour recurrence.
The study, a retrospective multicentre analysis, examined 183 brain lesions in 128 patients (median age: 61 years; range: 31–95 years) who had undergone stereotactic radiotherapy. Of these patients, 57% received a single fraction of radiotherapy, while 43% underwent fractionated treatment. Researchers focused on identifying which patients were at a higher risk of recurrence by analysing morphological features from contrast-enhanced (CE) T1-weighted magnetic resonance images. These features included total and necrotic tumour volumes, surface regularity, and CE rim width.
Interestingly, none of the variables measured at the time of diagnosis were found to have prognostic value. However, the study revealed that certain features measured at the first follow-up after treatment were significant predictors of recurrence. Specifically, the total and necrotic volumes of the tumours, the width of the CE rim, and the changes in tumour volume due to irradiation emerged as key biomarkers.
The most accurate predictions were made by combining the changes in tumour volume before and after treatment with the presence or absence of necrosis. This combination was highly significant (P<0.001) in predicting which lesions were likely to recur.
The study’s findings highlight the importance of post-treatment imaging in assessing the risk of recurrence in patients with BMs. By identifying these biomarkers, clinicians may be better equipped to adjust treatment plans and implement more targeted interventions to prevent tumour recurrence.
Ada Enesco, EMJ
Reference
Ocaña-Tienda B et al. Morphological MRI features as prognostic indicators in brain metastases. Cancer Imaging. 2024;24(1):111.
