{"corpus_id":206744982,"paper_sha":"d3372c9a58bcaa12ce9e56185af6c35b284a6435","doi":"10.1177/1533034617705715","arxiv_id":null,"pmid":28449626,"pmcid":"5762041","mag_id":2608470276,"dblp_id":null,"acl_id":null,"title":"A Pilot Study Evaluating the Use of Dynamic Contrast-Enhanced Perfusion MRI to Predict Local Recurrence After Radiosurgery on Spinal Metastases","year":2017,"publication_date":"2017-04-28","venue":"Technology in Cancer Research and Treatment","journal":{"name":"Technology in Cancer Research & Treatment","pages":"857 - 865","volume":"16"},"journal_issn":null,"journal_title":null,"publication_types":["JournalArticle"],"pubmed_pub_types":["Journal Article"],"s2_fields_of_study":["Medicine","Engineering"],"reference_count":29,"citation_count":61,"influential_citation_count":2,"is_open_access":true,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":null,"chemicals":null,"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":"https://journals.sagepub.com/doi/pdf/10.1177/1533034617705715","s2_open_access_landing_url":"https://www.semanticscholar.org/paper/d3372c9a58bcaa12ce9e56185af6c35b284a6435","s2_open_access_license":"CCBYNC","s2_open_access_status":"HYBRID","pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"Purpose: Dynamic contrast-enhanced magnetic resonance imaging offers noninvasive characterization of the vascular microenvironment and hemodynamics. Stereotactic radiosurgery, or stereotactic body radiation therapy, engages a vascular component of the tumor response which may be detectable using dynamic contrast-enhanced magnetic resonance imaging. The purpose of this study is to examine whether dynamic contrast-enhanced magnetic resonance imaging can be used to predict local tumor recurrence in patients with spinal bone metastases who undergo high-dose radiotherapy with stereotactic radiosurgery. Materials and Methods: We conducted a study of 30 patients with spinal metastases who underwent dynamic contrast-enhanced magnetic resonance imaging before and after radiotherapy. Twenty patients received single-fraction stereotactic radiosurgery (24 Gy), while 10 received hypofractionated stereotactic radiosurgery (3-5 fractions, 27-30 Gy total). Kaplan-Meier analysis was used to estimate the actuarial local recurrence rates. Two perfusion parameters (Ktrans: permeability and Vp: plasma volume) were measured for each metastasis. Percentage change in parameter values from pre- to posttreatment was calculated and compared. Results: At 20-month median follow-up, 5 of the 30 patients had pathological evidence of local recurrence. One- and 3-year actuarial local recurrence rates were 24% and 44% for the hypofractionated stereotactic radiosurgery cohort versus 5% and 16% for the single-fraction stereotactic radiosurgery cohort (P = .20). The average change in Vp and Ktrans for patients without local recurrence versus those with local recurrence was −76% and −66% versus +28% and −14% (P < .01 for both). With a cutoff point of −20%, Vp had a sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 98%, 91%, and 100%, respectively, for the detection of local recurrence following high-dose radiotherapy. Using this definition, dynamic contrast-enhanced magnetic resonance imaging identified local recurrence up to 18 months (mean [standard deviation], 6.6 [6.8] months) earlier than standard magnetic resonance imaging. Conclusions: We demonstrated that changes in perfusion parameters, particularly Vp, after high-dose radiotherapy to spinal bone metastases were predictive of local tumor recurrence. These changes predicted local recurrence on average >6 months earlier than standard imaging did.","claims":[{"public_id":"cl_49b30238ccfe6df7d86d2b5ae963c1cc","status":"active","text":"Changes in perfusion parameters after high-dose radiotherapy to spinal bone metastases were predictive of local tumor recurrence.","confidence":0.98,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_49b30238ccfe6df7d86d2b5ae963c1cc"},{"public_id":"cl_f2a87798d92a8e4d0d7bc067d38a11cd","status":"active","text":"Dynamic contrast-enhanced magnetic resonance imaging identified local recurrence on average more than 6 months earlier than standard magnetic resonance imaging.","confidence":0.95,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous 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100%.","confidence":0.97,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_6f04937aeb68cbabdda87aa6410d5795"}],"concepts":[{"public_id":"co_0c57b0536a9cc69fbf0311d47f6b36bb","status":"active","name":"dynamic contrast-enhanced magnetic resonance imaging","description":"An MRI technique that tracks contrast uptake over time to characterize tissue perfusion and vascular properties.","types":["imaging method"],"aliases":["DCE MRI","DCE-MRI"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_0c57b0536a9cc69fbf0311d47f6b36bb"},{"public_id":"co_180c8b2887325be176f3963475b3b325","status":"active","name":"perfusion parameters","description":"Quantitative imaging measures derived from contrast-enhanced MRI that 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