Stereotactic radiosurgery (SRS) has transformed the management of brain metastases by achieving local tumor control, reducing toxicity, and minimizing the need for whole-brain radiation therapy (WBRT). This review specifically investigates radiation-induced changes in patients treated for metastasis, highlighting the crucial role of magnetic resonance imaging (MRI) in the evaluation of treatment response, both at very early and late stages. The primary objective of the review is to evaluate the most effective imaging techniques for assessing radiation-induced changes and distinguishing them from tumor growth. The limitations of conventional imaging methods, which rely on size measurements, dimensional criteria, and contrast enhancement patterns, are critically evaluated. In addition, it has been investigated the potential of advanced imaging modalities to offer a more precise and comprehensive evaluation of treatment response. Finally, an overview of the relevant literature concerning the interpretation of brain changes in patients undergoing immunotherapies is provided.
立体定向放射外科（SRS）通过实现局部肿瘤控制、降低毒性反应并减少全脑放疗（WBRT）需求，彻底改变了脑转移瘤的治疗策略。本综述聚焦于转移瘤患者放疗后引发的影像学改变，重点探讨磁共振成像（MRI）在治疗早期及晚期疗效评估中的关键作用。综述的核心目标在于评估现有影像学技术对放疗后改变的检测效能及其与肿瘤进展的鉴别价值，并对依赖尺寸测量、形态学标准及强化模式的传统影像评估方法的局限性进行批判性分析。同时，本文探讨了先进影像技术在实现更精准、全面疗效评估方面的潜力。最后，综述对接受免疫治疗患者脑部影像改变的解读相关文献进行了系统性梳理。
Radiosurgery for Brain Metastases: Challenges in Imaging Interpretation after Treatment
肿瘤(癌症)患者之家