Article Figures & Data
Figures
- FIG 1.
Flow diagram for patient selection and exclusion.
- FIG 2.
Unenhanced T2 FLAIR (A), T2FLAIRc (B), and T1c (C) are shown for a treated brain metastasis in the left temporal lobe (a case of radiation necrosis). T2FLAIRc demonstrates hybrid contrast between T2 FLAIR and T1c with edema (yellow arrow) and contrast enhancement (red arrow).
- FIG 3.
Histograms and boxplots illustrating the complete set of all enhancing voxels across all patients with TP and RN for T2FLAIRc and T1c. Mean signal intensities for each group are indicated in the figure legends for the histograms. The boxplots depict the mean and IQR. P values for unpaired t tests are shown and considered significant at P < .05.
- FIG 4.
ROC curves for T2FLAIRc, T1c, and rCBV from DSC perfusion. The AUC for T2FLAIRc was significantly higher compared with T1c (P = .04) but not for rCBV (P = .9). FPR indicates false-positive rate; TPR, true-positive rate.
- FIG 5.
Comparison of a T2FLAIRc z score parameter map with the rCBV map for cases of TP (upper row) and RN (lower row). A and E, Axial T1c MPRAGE. B and F, Corresponding T2FLAIRc. C and G, T2FLAIRc z score for enhancing tumor voxels overlayed on T1c images shows lower values (mean, 5.8 [SD 2.0]) for TP and higher values (mean, 12.6 [SD 5.7]) for RN. D and H, The rCBV map from follow-up dynamic susceptibility perfusion MRI shows higher values for TP (mean, 4.8 [SD 2.3]) and lower values for RN (mean, 1.3 [SD 1.2]).
Tables
Patient and tumor characteristicsa
Characteristic Total (n = 56) Tumor Progression (n = 28) Radiation Necrosis (n = 28) P Value Age (yr) 61.9 ± 12.7 60.2 ± 12.5 63.6 ± 12.8 .32 Sex 1.00 Male 17 (30.4%) 8 (28.5%) 9 (32%) Female 39 (69.6%) 20 (71.4%) 19 (68%) Primary cancer type .50 NSCLC 25 (44.6%) 14 (50%) 11 (39.2%) Breast 18 (32.1%) 9 (32.1%) 9 (32.1%) Melanoma 4 (7.1%) 1 (3.6%) 3 (10.7%) RCC 4 (7.1%) 1 (3.6%) 3 (10.7%) Other 5 (8.9%) 3 (10.7%) 2 (7.1%) Total dose (Gy) 25 (IQR,20–30) 23.3 (IQR,19.5–27.5) 27.3 (IQR,20–30) .25 No. of fractions 3 (IQR, 1–5) 3 (IQR, 1–5) 5 (IQR, 1–5) .72 Time from SRS to DSC (days) 358 (IQR, 262− 86) 394 (IQR, 347−586) 296 (IQR, 222−588) .06 Time from index MR to DSC (days) 73 [SD, 34] 68 [SD, 32] 78 [SD, 35] .30 Systemic therapy 25 (44.6%) 12 (42.9%) 13 (46.4%) 1.00 Lesion outcome .76 Pathology 14 (25%) 8 (29%) 6 (21%) Follow-up 42 (75%) 20 (71%) 22 (79%) Scanner field strength .42 1.5T 28 (50%) 16 (57%) 12 (43%) 3T 28 (50%) 12 (43%) 16 (57%) Note:—NSCLC indicates non-small cell lung cancer; RCC, renal cell carcinoma.
a Categoric variables are presented as a proportion or percentage of patients. Continuous variables are presented as a mean (SD) for normally distributed variables and median (IQR) for non-normally distributed variables. Categoric variables were compared using the χ2 or Fisher exact test, when appropriate. Continuous variables were compared using the Wilcoxon rank-sum test for nonparametric group comparisons and the t test for parametric group comparisons. Results were considered significant with P < .05.
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