Verlaufsbeobachtung bestrahlter hirnmetastasen mittels MR-perfusionsbildgebung und 1H-MR-spektroskopie

Translated title of the contribution: Monitoring of irradiated brain metastases using MR perfusion imaging and 1H MR spectroscopy

Marc André Weber, M. P. Lichy, C. Thilmann, M. Günther, P. Bachert, Andrew A Maudsley, S. Delorme, L. R. Schad, J. Debus, H. P. Schlermmer

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose. In follow-up examinations of irradiated brain metastases conventional contrast-enhanced morphological MR imaging is often unable to distinguish between transient radiation effects, radionecrosis, and tumor recurrence. To evaluate changes of relative cerebral blood flow (rCBF) in irradiated brain metastases arterial spin-labeling techniques (ASL) were applied and compared to the outcome of 1H MR spectroscopy and spectroscopic imaging (1H MRS, SI). Patients and methods. In 2 patients followup examinations of irradiated brain metastases were performed on a 1.5-T tomograph (average single dose: 20 Gy/80% isodose). Relative CBF values of gray matter (GM), white matter (WM), and metastases (Met) were measured by means of the ASL techniques ITS-FAIR and Q2TIPS. 1H MRS was performed with PRESS 1500/135. Results. In both patients with initially hyperperfused metastases (Met/GM > 1) the reduction of rCBF after stereotactic radiosurgery indicated response to treatment - even if the contrast-enhancing region increased - while increasing rCBF values indicated tumor progression. The findings were confirmed by 1H MRS, SI and subsequent follow-up. Conclusion. The ASL techniques ITS-FAIR and Q2TIPS are able to monitor changes of rCBF in irradiated brain metastases. The two cases imply a possible role for ASL-MR perfusion imaging and 1H MR spectroscopy in differentiating radiation effects from tumor progression.

Original languageGerman
Pages (from-to)388-395
Number of pages8
JournalRadiologe
Volume43
Issue number5
DOIs
StatePublished - May 1 2003
Externally publishedYes

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Perfusion Imaging
Cerebrovascular Circulation
Magnetic Resonance Spectroscopy
Neoplasm Metastasis
Brain
Radiation Effects
Neoplasms
Radiosurgery
Recurrence

Keywords

  • H MR spectroscopy
  • Brain metastases
  • MR perfusion imaging
  • Radiation effects
  • Radiotherapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Weber, M. A., Lichy, M. P., Thilmann, C., Günther, M., Bachert, P., Maudsley, A. A., ... Schlermmer, H. P. (2003). Verlaufsbeobachtung bestrahlter hirnmetastasen mittels MR-perfusionsbildgebung und 1H-MR-spektroskopie. Radiologe, 43(5), 388-395. https://doi.org/10.1007/s00117-003-0887-6

Verlaufsbeobachtung bestrahlter hirnmetastasen mittels MR-perfusionsbildgebung und 1H-MR-spektroskopie. / Weber, Marc André; Lichy, M. P.; Thilmann, C.; Günther, M.; Bachert, P.; Maudsley, Andrew A; Delorme, S.; Schad, L. R.; Debus, J.; Schlermmer, H. P.

In: Radiologe, Vol. 43, No. 5, 01.05.2003, p. 388-395.

Research output: Contribution to journalArticle

Weber, MA, Lichy, MP, Thilmann, C, Günther, M, Bachert, P, Maudsley, AA, Delorme, S, Schad, LR, Debus, J & Schlermmer, HP 2003, 'Verlaufsbeobachtung bestrahlter hirnmetastasen mittels MR-perfusionsbildgebung und 1H-MR-spektroskopie', Radiologe, vol. 43, no. 5, pp. 388-395. https://doi.org/10.1007/s00117-003-0887-6
Weber, Marc André ; Lichy, M. P. ; Thilmann, C. ; Günther, M. ; Bachert, P. ; Maudsley, Andrew A ; Delorme, S. ; Schad, L. R. ; Debus, J. ; Schlermmer, H. P. / Verlaufsbeobachtung bestrahlter hirnmetastasen mittels MR-perfusionsbildgebung und 1H-MR-spektroskopie. In: Radiologe. 2003 ; Vol. 43, No. 5. pp. 388-395.
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abstract = "Purpose. In follow-up examinations of irradiated brain metastases conventional contrast-enhanced morphological MR imaging is often unable to distinguish between transient radiation effects, radionecrosis, and tumor recurrence. To evaluate changes of relative cerebral blood flow (rCBF) in irradiated brain metastases arterial spin-labeling techniques (ASL) were applied and compared to the outcome of 1H MR spectroscopy and spectroscopic imaging (1H MRS, SI). Patients and methods. In 2 patients followup examinations of irradiated brain metastases were performed on a 1.5-T tomograph (average single dose: 20 Gy/80{\%} isodose). Relative CBF values of gray matter (GM), white matter (WM), and metastases (Met) were measured by means of the ASL techniques ITS-FAIR and Q2TIPS. 1H MRS was performed with PRESS 1500/135. Results. In both patients with initially hyperperfused metastases (Met/GM > 1) the reduction of rCBF after stereotactic radiosurgery indicated response to treatment - even if the contrast-enhancing region increased - while increasing rCBF values indicated tumor progression. The findings were confirmed by 1H MRS, SI and subsequent follow-up. Conclusion. The ASL techniques ITS-FAIR and Q2TIPS are able to monitor changes of rCBF in irradiated brain metastases. The two cases imply a possible role for ASL-MR perfusion imaging and 1H MR spectroscopy in differentiating radiation effects from tumor progression.",
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AU - Lichy, M. P.

AU - Thilmann, C.

AU - Günther, M.

AU - Bachert, P.

AU - Maudsley, Andrew A

AU - Delorme, S.

AU - Schad, L. R.

AU - Debus, J.

AU - Schlermmer, H. P.

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N2 - Purpose. In follow-up examinations of irradiated brain metastases conventional contrast-enhanced morphological MR imaging is often unable to distinguish between transient radiation effects, radionecrosis, and tumor recurrence. To evaluate changes of relative cerebral blood flow (rCBF) in irradiated brain metastases arterial spin-labeling techniques (ASL) were applied and compared to the outcome of 1H MR spectroscopy and spectroscopic imaging (1H MRS, SI). Patients and methods. In 2 patients followup examinations of irradiated brain metastases were performed on a 1.5-T tomograph (average single dose: 20 Gy/80% isodose). Relative CBF values of gray matter (GM), white matter (WM), and metastases (Met) were measured by means of the ASL techniques ITS-FAIR and Q2TIPS. 1H MRS was performed with PRESS 1500/135. Results. In both patients with initially hyperperfused metastases (Met/GM > 1) the reduction of rCBF after stereotactic radiosurgery indicated response to treatment - even if the contrast-enhancing region increased - while increasing rCBF values indicated tumor progression. The findings were confirmed by 1H MRS, SI and subsequent follow-up. Conclusion. The ASL techniques ITS-FAIR and Q2TIPS are able to monitor changes of rCBF in irradiated brain metastases. The two cases imply a possible role for ASL-MR perfusion imaging and 1H MR spectroscopy in differentiating radiation effects from tumor progression.

AB - Purpose. In follow-up examinations of irradiated brain metastases conventional contrast-enhanced morphological MR imaging is often unable to distinguish between transient radiation effects, radionecrosis, and tumor recurrence. To evaluate changes of relative cerebral blood flow (rCBF) in irradiated brain metastases arterial spin-labeling techniques (ASL) were applied and compared to the outcome of 1H MR spectroscopy and spectroscopic imaging (1H MRS, SI). Patients and methods. In 2 patients followup examinations of irradiated brain metastases were performed on a 1.5-T tomograph (average single dose: 20 Gy/80% isodose). Relative CBF values of gray matter (GM), white matter (WM), and metastases (Met) were measured by means of the ASL techniques ITS-FAIR and Q2TIPS. 1H MRS was performed with PRESS 1500/135. Results. In both patients with initially hyperperfused metastases (Met/GM > 1) the reduction of rCBF after stereotactic radiosurgery indicated response to treatment - even if the contrast-enhancing region increased - while increasing rCBF values indicated tumor progression. The findings were confirmed by 1H MRS, SI and subsequent follow-up. Conclusion. The ASL techniques ITS-FAIR and Q2TIPS are able to monitor changes of rCBF in irradiated brain metastases. The two cases imply a possible role for ASL-MR perfusion imaging and 1H MR spectroscopy in differentiating radiation effects from tumor progression.

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