Prognostic Value of MR Imaging Texture Analysis in Brain Non-Small Cell Lung Cancer Oligo-Metastases Undergoing Stereotactic Irradiation

• Published in: Curēus (Palo Alto, CA) CA), 2016-04, Vol.8 (4), p.e584-e584
• Main Authors: Nardone, Valerio, Tini, Paolo, Biondi, Michelangelo, Sebaste, Lucio, Vanzi, Eleonora, De Otto, Gianmarco, Rubino, Giovanni, Carfagno, Tommaso, Battaglia, Giuseppe, Pastina, Pierpaolo, Cerase, Alfonso, Mazzoni, Lorenzo Nicola, Banci Buonamici, Fabrizio, Pirtoli, Luigi
• Format: Article
• Language: English
• Subjects: Brain cancer; Lung cancer; Medical Physics; Metastasis; Oncology; Radiation Oncology
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.584

BACKGROUND : Stereotactic irradiation is widely used in brain oligo-metastases treatment. The aim of this study is to evaluate the prognostic value of magnetic resonance imaging (MRI) texture analysis (TA) of brain metastases (BM) of non-small cell lung cancer (NSCLC). MATERIALS AND METHODS : This study included thirty-eight consecutive patients undergoing stereotactic irradiation, that is, stereotactic fractionated radiotherapy (SRT) or radiosurgery (SRS), from January 2011 to December 2014 for 1-2 brain BM from NSCLC. Whole-brain radiotherapy (WBRT) was not delivered. The diagnostic MRI DICOM (Digital Imaging and Communications in Medicine) images were collected and analyzed with a homemade ImageJ macro, and typical TA parameters (mean, standard deviation, skewness, kurtosis, entropy, and uniformity) were evaluated for: brain progression-free survival; modality of brain metastatic progression (local progression or/and new metastases); and overall survival, after SRT/SRS. After SRT/SRS 14 patients (36.8%) experienced recurrence in the brain, with a recurrence in the irradiated site (five patients, 13.2%), new metastases (11 patients, 28.9%), local recurrence and new metastases (two patients, 5.25%). Nineteen patients (50%) died of tumor progression or other causes. Entropy and uniformity were significantly associated with local progression, whereas kurtosis was significantly associated with both local progression and new brain metastases. CONCLUSIONS : These results appear promising, since the knowledge of factors correlated with the modality of brain progression after stereotactic irradiation of brain oligo-metastatic foci of NSCLC might help in driving the best treatment in these patients (association of SRT/SRS with WBRT? Increase of SRT/SRS dose?). Our preliminary data needs confirmation in large patient series.