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Abstract
This study aims to evaluate the utility of texture analysis in predicting the outcome of stereotactic radiosurgery (SRS) for brain metastases from lung cancer. From 83 patients with lung cancer who underwent SRS for brain metastasis, a total of 118 metastatic lesions were included. Two neuroradiologists independently performed magnetic resonance imaging (MRI)-based texture analysis using the Imaging Biomarker Explorer software. Inter-reader reliability as well as univariable and multivariable analyses were performed for texture features and clinical parameters to determine independent predictors for local progression-free survival (PFS) and overall survival (OS). Furthermore, Harrell’s concordance index (C-index) was used to assess the performance of the independent texture features. The primary tumor histology of small cell lung cancer (SCLC) was the only clinical parameter significantly associated with local PFS in multivariable analysis. Run-length non-uniformity (RLN) and short-run emphasis were the independent texture features associated with local PFS. In the non-SCLC (NSCLC) subgroup analysis, RLN and local range mean were associated with local PFS. The C-index of independent texture features was 0.79 for the all-patients group and 0.73 for the NSCLC subgroup. In conclusion, texture analysis on pre-treatment MRI of lung cancer patients with brain metastases may have a role in predicting SRS response.
Highlights
Lung cancer is the most common cancer that metastasizes to the brain [1]
Increasing evidence suggests that there is no difference in the overall survival rates of affected patients receiving Stereotactic radiosurgery (SRS) coupled with whole-brain radiotherapy (WBRT) and those receiving SRS alone
Those who met the following criteria were included in this study: (a) initial diagnosis of primary lung cancer by histopathology and (b) available pre-treatment brain Magnetic resonance imaging (MRI), including 1 mm thickness T1-weighted image (T1WI, pre- and post-contrast administration) and T2-weighted image (T2WI)
Summary
Lung cancer incidence is on the rise; survival rates are increasing because of early diagnosis and the development of effective therapies [2]. As long-term survival outcomes in lung cancer patients continue to improve, the burden of brain metastases will inevitably grow, necessitating the need for optimal therapeutic options with low toxicity to manage brain metastases [3]. Increasing evidence suggests that there is no difference in the overall survival rates of affected patients receiving SRS coupled with whole-brain radiotherapy (WBRT) and those receiving SRS alone. Magnetic resonance imaging (MRI) is important for both the early diagnosis of, as well as guiding optimal treatment strategies for brain metastasis. Utilizing information obtained from brain MRIs is essential for the successful treatment of patients with brain metastasis
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