| Comparative Analysis of Tumor Volumes between Immediate and 20-Minute Delayed MR Image after Gadovist Injection |
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Ki Wan Kim, Eun-Jeong Koh, Jung Soo Park, Ha Young Choi |
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Department of Neurosurgery, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea |
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| Abstract |
Objective
Small metastatic lesion can be overlooked by radiologists in diagnosis and clinicians in planning of radiosurgical treatment. We studied the differences in visualization of the new lesion between immediate and 20-minute delayed image and in change of volume measurement of the lesions during gamma knife radiosurgery (GKRS).
Materials and Methods: This study included 16 patients with multiple brain metastases in MRI. Two observers (A, B) counted the lesions and measured the volume in immediate and 20-minute delayed images by Leksell gamma plan (version 10, Elekta, Sweden), independently. We compared the volume and the numbers of lesions between data obtained by two observers.
Results
Pathologic diagnosis showed adenocarcinoma in 12 patients, squamous cell carcinoma in two, small cell lung cancer in one, and sarcomatoid cancer in one. Total 64 lesions were analyzed (adenocarcinoma 52, squamous cell cardinoma 8, SCLC 1, sarcomatoid cancer 1). Increased volumes in delayed image were measured in 51 lesions (80%) by observer A and in forty eight lesions (75%) by observer B. Decreased volume were measured in six lesions (9%) by both observers. In fifteen lesions (23%), reversed data between observer A and B were obtained in volume measurement. Both A and B observers detected four new lesions (6%) in 20-minute delayed image which were not visuzalzed in immediate image.
Conclusion
In spite of small numbers of this study, it was of value in planning for GKRS to use immediate and 20-minute delayed MRI simultaneously in visualization and volume measurement of the small metastatic lesions. 20-minute delayed MRI was a useful method to visualize the new lesion. |
| Key Words:
Brain metastasis, Delayed MRI, Gamma knife radiosurgery. |
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