ArticleAJNR. American journal of neuroradiology2025
Gadolinium-Enhanced T2 FLAIR Is an Imaging Biomarker of Radiation Necrosis and Tumor Progression in Patients with Brain Metastases.
Article in AJNR. American journal of neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Post-therapy imaging of adult brain tumours: patterns, pitfalls, and practical framework.Insights into imaging · 2026Article
- A transformer-based multimodal deep learning model for preoperative prediction of Ki-67 expression level in glioma.BMC medical imaging · 2026Article
- Equity and Generalizability of Radiomics in Orbital Disease: Challenges for Ophthalmology, Otolaryngology, and Plastic Surgery.Diagnostics (Basel, Switzerland) · 2026Review
- Applications of Advanced Imaging for Radiotherapy Planning and Response Assessment in the Central Nervous System.Tomography (Ann Arbor, Mich.) · 2025Review
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18 authors.
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Abstract
background and purposeDifferentiating radiation necrosis (RN) from tumor progression (TP) after radiation therapy for brain metastases is an important clinical problem requiring advanced imaging techniques that may not be widely available and are challenging to perform at multiple time points. The ability to leverage conventional MRI for this problem could have a meaningful clinical impact. The purpose of this study was to explore contrast-enhanced T2 FLAIR (T2FLAIRc) as a new imaging biomarker of RN and TP. MATERIALS AND
methodsThis single-institution retrospective study included patients with treated brain metastases undergoing DSC-MRI between January 2021 and June 2023. Reference standard assessment was based on histopathology or serial follow-up, including the results of DSC-MRI for a minimum of 6 months from the first DSC-MRI. The index test was implemented as part of the institutional brain tumor MRI protocol and preceded the first DSC-MRI. T2FLAIRc and gadolinium-enhanced T1 (T1c) MPRAGE signal were normalized against normal brain parenchyma and expressed as a
resultsFifty-six participants (mean age, 62 [SD, 12.7] years; 39 women; 28 with RN, 28 with TP) were evaluated. The index MRI was performed, on average, 73 [SD, 34] days before the first DSC-MRI. Significantly higher
conclusionsA higher normalized T1c and T2FLAIRc signal intensity was found for RN. In a univariable test, the mean T2FLAIRc signal intensity of enhancing voxels showed good discrimination performance for distinguishing RN from TP. The results of this work demonstrate the potential of T2FLAIRc as an imaging biomarker in the work-up of RN in patients with brain metastases.
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