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Clinical outcomes of brain metastases treated with G amma K nife radiosurgery with 3.0 T versus 1.5 T MRI ‐based treatment planning: Have we finally optimised detection of occult brain metastases?
Author(s) -
Loganathan Amritraj G,
Chan Michael D,
Alphonse Natalie,
Peiffer Ann M,
Johnson Annette J,
McMullen Kevin P,
Urbanic James J,
Saconn Paul A,
Bourland J Daniel,
Munley Michael T,
Shaw Edward G,
Tatter Stephen B,
Ellis Thomas L
Publication year - 2012
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/j.1754-9485.2012.02429.x
Subject(s) - medicine , radiosurgery , occult , cohort , radiation therapy , radiology , nuclear medicine , radiation treatment planning , pathology , alternative medicine
Abstract Introduction The goal of this study was to determine if clinically relevant endpoints were changed by improved MRI resolution during radiosurgical treatment planning. Methods and Materials Between 2003 and 2008, 200 consecutive patients with brain metastases treated with Gamma Knife radiosurgery ( GKRS ) using either 1.5 T or 3.0 T MRI for radiosurgical treatment planning were retrospectively analysed. The number of previously undetected metastases at time of radiosurgery, distant brain failures, time delay to whole brain radiotherapy ( WBRT ), overall survival and likelihood of neurological death were determined. Results Additional metastases were detected in 31.3% and 24.5% of patients at time of radiosurgery with 3.0 T and 1.5 T MRI , respectively ( P = 0.27). Patients with multiple metastases at diagnostic scan were more likely to have additional metastases detected by 3.0 T MRI ( P < 0.1). Median time to distant brain failure was 4.87 months and 5.43 months for the 3.0 T and 1.5 T cohorts, respectively ( P = 0.44). Median time to WBRT was 5.8 months and 5.3 months for the 3.0 T and 1.5 T cohorts, respectively ( P = 0.87). Median survival was 6.4 months for the 3.0 T cohort, and 6.1 months for the 1.5 T cohort ( P = 0.71). Likelihood of neurological death was 25.3% and 16.7% for the 3.0 and 1.5 T populations, respectively ( P = 0.26). Conclusions The 3.0 T MRI ‐based treatment planning for GKRS did not appear to affect the likelihood of distant brain failure, the need for WBRT or the likelihood of neurological death in this series.