文章：

评估接受立体定向放射外科治疗的脑转移患者生理性MRI参数——初步分析与病例报告

Evaluating Physiological MRI Parameters in Patients with Brain Metastases Undergoing Stereotactic Radiosurgery—A Preliminary Analysis and Case Report

原文发布日期：28 August 2023

DOI: 10.3390/cancers15174298

类型: Article

开放获取: 是

英文摘要：

Brain metastases occur in ten to thirty percent of the adult cancer population. Treatment consists of different (palliative) options, including stereotactic radiosurgery (SRS). Sensitive MRI biomarkers are needed to better understand radiotherapy-related effects on cerebral physiology and the subsequent effects on neurocognitive functioning. In the current study, we used physiological imaging techniques to assess cerebral blood flow (CBF), oxygen extraction fraction (OEF), cerebral metabolic rate of oxygen (CMRO2) and cerebrovascular reactivity (CVR) before and three months after SRS in nine patients with brain metastases. The results showed improvement in OEF, CBF and CMRO2within brain tissue that recovered from edema (allp≤ 0.04), while CVR remained impacted. We observed a global post-radiotherapy increase in CBF in healthy-appearing brain tissue (p= 0.02). A repeated measures correlation analysis showed larger reductions within regions exposed to higher radiotherapy doses in CBF (rrm= −0.286,p< 0.001), CMRO2(rrm= −0.254,p< 0.001), and CVR (rrm= −0.346,p< 0.001), but not in OEF (rrm= −0.004,p= 0.954). Case analyses illustrated the impact of brain metastases progression on the post-radiotherapy changes in both physiological MRI measures and cognitive performance. Our preliminary findings suggest no radiotherapy effects on physiological parameters occurred in healthy-appearing brain tissue within 3-months post-radiotherapy. Nevertheless, as radiotherapy can have late side effects, larger patient samples allowing meaningful grouping of patients and longer follow-ups are needed.

摘要翻译： 

脑转移发生于10%至30%的成年癌症患者。治疗方案包含多种（姑息性）选择，其中立体定向放射外科（SRS）是常用手段之一。为深入理解放疗对脑生理功能的影响及其后续对神经认知功能的作用，需要敏感的MRI生物标志物。本研究采用生理成像技术，对9例脑转移患者于SRS治疗前及治疗后三个月分别评估了脑血流量（CBF）、氧摄取分数（OEF）、脑氧代谢率（CMRO2）及脑血管反应性（CVR）。结果显示，在从水肿恢复的脑组织区域内，OEF、CBF及CMRO2均有所改善（所有p值≤0.04），而CVR仍受影响。我们观察到放疗后外观健康的脑组织中CBF整体性升高（p=0.02）。重复测量相关性分析表明，在受到较高放疗剂量的区域内，CBF（rrm=−0.286，p<0.001）、CMRO2（rrm=−0.254，p<0.001）及CVR（rrm=−0.346，p<0.001）均出现更显著的下降，但OEF未见明显变化（rrm=−0.004，p=0.954）。病例分析揭示了脑转移进展对放疗后生理MRI指标及认知功能变化的影响。我们的初步研究结果表明，在放疗后三个月内，外观健康的脑组织未出现放疗相关的生理参数改变。然而，由于放疗可能具有远期副作用，未来需要更大样本量的患者群体以进行有效的分组分析，并开展更长期的随访研究。

原文链接：

Evaluating Physiological MRI Parameters in Patients with Brain Metastases Undergoing Stereotactic Radiosurgery—A Preliminary Analysis and Case Report