Rofo 2017; 189(S 01): S1-S124
DOI: 10.1055/s-0037-1600412
Vortrag (Wissenschaft)
Onkologische Bildgebung/Onkologie
Georg Thieme Verlag KG Stuttgart · New York

3D imaging biomarkers for the prediction of survival in patients with non-small cell lung cancer brain metastases treated with stereotactic body radiation therapy

M Della Seta
1   Charité Universitätsmedizin Berlin, Radiologie, Berlin
,
D Kaul
2   Charité Universitätsmedizin Berlin, Strahlentherapie, Berlin
,
J Chapiro
3   Yale School of Medicine, Radiologie, New Haven
,
B Hamm
1   Charité Universitätsmedizin Berlin, Radiologie, Berlin
,
F Collettini
1   Charité Universitätsmedizin Berlin, Radiologie, Berlin
› Author Affiliations
Further Information

Publication History

Publication Date:
23 March 2017 (online)

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Zielsetzung:

The aim of the present study was to investigate the value of 3D quantitative tissue enhancement as an early imaging biomarker for patient survival in patients with non-small cell lung cancer (NSCLC) brain metastases treated with stereotactic body radiation therapy (SBRT).

Material und Methodik:

This retrospective analysis included 27 patients with NSCLC brain metastasis who were treated with SBRT. Baseline contrast-enhanced MRI (ceMRI), acquired within a mean of 30 days before therapy, was used for image analysis using the qEASL tool (IntelliSpace Portal V.8, Philips Healthcare). A segmentation-based 3D quantification was performed in each patient to measure the relative tumor enhancement in each lesion. A cutoff value of 65% lesion enhancement was used to stratify the patient cohort in two groups (< 65% and > 65% volumetric lesion enhancement). Survival was evaluated using Kaplan-Meier analysis and compared using the Mantel-Cox Log-rang test as well as proportional hazard ratios (HR).

Ergebnisse:

Median OS of the entire population was 6.0 months. The stratification of the cohort according to the 65% cutoff for the relative enhancing tumor volume achieved statistical significance p = 0.0452 (HR, 2.2 [95% CI, 1.1 – 6.8]). Patients with > 65% enhancing lesion volume survived significantly longer than patients with relatively less-enhancing tumor lesions (8.15 months vs. 2,09 months [HR 0.25; 95% CI, 0.11 – 0.58], respectively). Stratification according to cutoffs for the total tumor volume did not achieve a statistically significant separation of survival curves.

Schlussfolgerungen:

As opposed to the total tumor volume which currently is one of the most commonly used staging marker, volumetric assessment of metastatic NSCLC lesion enhancement on baseline ceMRI is strongly associated with patient survival after SBRT. Specifically, patients with hyper-enhancing lesions demonstrated improved survival as compared to those with hypo-enhancing lesions.