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Correlating volumetric and linear measurements of brain metastases on MRI scans using intelligent automation software: a preliminary study

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Abstract

Purpose

The Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) working group proposed a guide for treatment responses for BMs by utilizing the longest diameter; however, despite recognizing that many patients with BMs have sub-centimeter lesions, the group referred to these lesions as unmeasurable due to issues with repeatability and interpretation. In light of RANO—BM recommendations, we aimed to correlate linear and volumetric measurements in sub-centimeter BMs on contrast-enhanced MRI using intelligent automation software.

Methods

In this retrospective study, patients with BMs scanned with MRI between January 1, 2018, and December 31, 2021, were screened. Inclusion criteria were: (1) at least one sub-centimeter BM with an integer millimeter-longest diameter was noted in the MRI report; (2) patients were a minimum of 18 years of age; (3) patients with available pre-treatment three-dimensional T1-weighted spoiled gradient-echo MRI scan. The screening was terminated when there were 20 lesions in each group. Lesion volumes were measured with the help of intelligent automation software Jazz (AI Medical, Zollikon, Switzerland) by two readers. The Kruskal-Wallis test was used to compare volumetric differences.

Results

Our study included 180 patients. The agreement for volumetric measurements was excellent between the two readers. The volumes of the following groups were not significantly different: 1–2 mm, 1–3 mm, 1–4 mm, 2–3 mm, 2–4 mm, 3–4 mm, 3–5 mm, 4–5 mm, 5–6 mm, 5–7 mm, 6–7 mm, 6–8 mm, 6–9 mm, 7–8 mm, 7–9 mm, 8–9 mm.

Conclusion

Our findings indicate that the largest diameter of a lesion may not accurately represent its volume. Additional research is required to determine which method is superior for measuring radiologic response to therapy and which parameter correlates best with clinical improvement or deterioration.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

mm:

Millimeter

Q1:

Lower quartile

IQR:

Interquartile range

Q3:

Upper quartile

SD:

Standard deviation

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Neuroradiology, MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA

    Burak B. Ozkara, Samir A. Dagher, Debajani Pattnaik, F. Eymen Ucisik, Melissa M. Chen & Max Wintermark

  2. Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, Zurich, CH-8032, Switzerland

    Christian Federau

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  7. Max Wintermark
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Contributions

Conceptualization: BBO, CF, FEU, MW; Data curation: BBO, SAD, DP, FEU, MMC; Formal Analysis: BBO, MW; Investigation: CF, FEU, MMC, MW; Methodology: BBO, FEU, MW; Software: BBO, CF; Validation: CF, FEU, MMC, MW; Visualization: BBO, CF; Supervision: FEU, MMC, MW; Writing—original draft: BBO, CF; Writing—review & editing: All authors.

Corresponding author

Correspondence to Max Wintermark.

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Competing interests

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board at The University of Texas MD Anderson Cancer Center.

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Ozkara, B.B., Federau, C., Dagher, S.A. et al. Correlating volumetric and linear measurements of brain metastases on MRI scans using intelligent automation software: a preliminary study. J Neurooncol 162, 363–371 (2023). https://doi.org/10.1007/s11060-023-04297-4

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