Skip to main content
Journal cover image

Incidence and imaging characteristics of difficult to detect retrospectively identified brain metastases in patients receiving repeat courses of stereotactic radiosurgery.

Publication ,  Journal Article
Fairchild, A; Salama, JK; Godfrey, D; Wiggins, WF; Ackerson, BG; Oyekunle, T; Niedzwiecki, D; Fecci, PE; Kirkpatrick, JP; Floyd, SR
Published in: J Neurooncol
March 2024

PURPOSE: During stereotactic radiosurgery (SRS) planning for brain metastases (BM), brain MRIs are reviewed to select appropriate targets based on radiographic characteristics. Some BM are difficult to detect and/or definitively identify and may go untreated initially, only to become apparent on future imaging. We hypothesized that in patients receiving multiple courses of SRS, reviewing the initial planning MRI would reveal early evidence of lesions that developed into metastases requiring SRS. METHODS: Patients undergoing two or more courses of SRS to BM within 6 months between 2016 and 2018 were included in this single-institution, retrospective study. Brain MRIs from the initial course were reviewed for lesions at the same location as subsequently treated metastases; if present, this lesion was classified as a "retrospectively identified metastasis" or RIM. RIMs were subcategorized as meeting or not meeting diagnostic imaging criteria for BM (+ DC or -DC, respectively). RESULTS: Among 683 patients undergoing 923 SRS courses, 98 patients met inclusion criteria. There were 115 repeat courses of SRS, with 345 treated metastases in the subsequent course, 128 of which were associated with RIMs found in a prior MRI. 58% of RIMs were + DC. 17 (15%) of subsequent courses consisted solely of metastases associated with + DC RIMs. CONCLUSION: Radiographic evidence of brain metastases requiring future treatment was occasionally present on brain MRIs from prior SRS treatments. Most RIMs were + DC, and some subsequent SRS courses treated only + DC RIMs. These findings suggest enhanced BM detection might enable earlier treatment and reduce the need for additional SRS.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Neurooncol

DOI

EISSN

1573-7373

Publication Date

March 2024

Volume

167

Issue

1

Start / End Page

219 / 227

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Radiosurgery
  • Oncology & Carcinogenesis
  • Magnetic Resonance Imaging
  • Incidence
  • Humans
  • Brain Neoplasms
  • 3211 Oncology and carcinogenesis
  • 3209 Neurosciences
  • 1112 Oncology and Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fairchild, A., Salama, J. K., Godfrey, D., Wiggins, W. F., Ackerson, B. G., Oyekunle, T., … Floyd, S. R. (2024). Incidence and imaging characteristics of difficult to detect retrospectively identified brain metastases in patients receiving repeat courses of stereotactic radiosurgery. J Neurooncol, 167(1), 219–227. https://doi.org/10.1007/s11060-024-04594-6
Fairchild, Andrew, Joseph K. Salama, Devon Godfrey, Walter F. Wiggins, Bradley G. Ackerson, Taofik Oyekunle, Donna Niedzwiecki, Peter E. Fecci, John P. Kirkpatrick, and Scott R. Floyd. “Incidence and imaging characteristics of difficult to detect retrospectively identified brain metastases in patients receiving repeat courses of stereotactic radiosurgery.J Neurooncol 167, no. 1 (March 2024): 219–27. https://doi.org/10.1007/s11060-024-04594-6.
Fairchild A, Salama JK, Godfrey D, Wiggins WF, Ackerson BG, Oyekunle T, et al. Incidence and imaging characteristics of difficult to detect retrospectively identified brain metastases in patients receiving repeat courses of stereotactic radiosurgery. J Neurooncol. 2024 Mar;167(1):219–27.
Fairchild, Andrew, et al. “Incidence and imaging characteristics of difficult to detect retrospectively identified brain metastases in patients receiving repeat courses of stereotactic radiosurgery.J Neurooncol, vol. 167, no. 1, Mar. 2024, pp. 219–27. Pubmed, doi:10.1007/s11060-024-04594-6.
Fairchild A, Salama JK, Godfrey D, Wiggins WF, Ackerson BG, Oyekunle T, Niedzwiecki D, Fecci PE, Kirkpatrick JP, Floyd SR. Incidence and imaging characteristics of difficult to detect retrospectively identified brain metastases in patients receiving repeat courses of stereotactic radiosurgery. J Neurooncol. 2024 Mar;167(1):219–227.
Journal cover image

Published In

J Neurooncol

DOI

EISSN

1573-7373

Publication Date

March 2024

Volume

167

Issue

1

Start / End Page

219 / 227

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Radiosurgery
  • Oncology & Carcinogenesis
  • Magnetic Resonance Imaging
  • Incidence
  • Humans
  • Brain Neoplasms
  • 3211 Oncology and carcinogenesis
  • 3209 Neurosciences
  • 1112 Oncology and Carcinogenesis