Evidence map›Paper›PMID 40097510›Full record

ArticleScientific reports2025

MRI distortion correction is associated with improved local control in stereotactic radiotherapy for brain metastases.

Daniel Höfler, Johanna Grigo, Hadi Siavosch, Marc Saake, Manuel Alexander Schmidt, Thomas Weissmann, Philipp Schubert, Raphaela Voigt, Sebastian Lettmaier, Sabine Semrau and 5 more

Abstract read
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Clinical and MRI factors influencing interobserver delineation variability of brain metastases before stereotactic radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Daniel HöflerDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany. daniel.hoefler@uk-erlangen.de.
Johanna GrigoDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Hadi SiavoschDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Marc SaakeInstitute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, Erlangen, Germany.
Manuel Alexander SchmidtDepartment of Neuroradiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, Germany.
Thomas WeissmannDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Philipp SchubertDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Raphaela VoigtDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Sebastian LettmaierDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Sabine SemrauDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Arnd DörflerDepartment of Neuroradiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, Germany.
Michael UderInstitute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, Erlangen, Germany.
Christoph BertDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Rainer FietkauDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.
Florian PutzDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.ORCID http://orcid.org/0000-0003-3966-2872

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Distortions in brain MRI caused by gradient nonlinearities may reach several millimeters, thus distortion correction is strongly recommended for radiotherapy treatment planning. However, the significance of MRI distortion correction on actual clinical outcomes has not been described yet. Therefore, we investigated the impact of planning MRI distortion correction on subsequent local control in a historic series of 419 brain metastases in 189 patients treated with stereotactic radiotherapy between 01/2003 and 04/2015. Local control was evaluated using a volumetric extension of the RANO-BM criteria. The predictive significance of distortion correction was assessed using competing risk analysis. In this cohort, 2D distortion-corrected MRIs had been used for treatment planning in 52.5% (220/419) of lesions, while uncorrected MRIs had been employed in 47.5% (199/419) of metastases. 2D distortion correction was associated with improved local control (Cumulative incidence of local progression at 12 months: 14.3% vs. 21.2% and at 24 months: 18.7% vs. 28.6%, p = 0.038). In multivariate analysis, adjusting for histology, baseline tumor volume, interval between MRI and treatment delivery, year of planning MRI, biologically effective dose and adjuvant Whole-brain radiotherapy, use of distortion correction remained significantly associated with improved local control (HR 0.55, p = 0.020). This is the first study to clinically evaluate the impact of MRI gradient nonlinearity distortion correction on local control in stereotactic radiotherapy for brain metastases. In this historic series, we found significantly higher local control when using 2D corrected vs. uncorrected MRI studies for treatment planning. These results stress the importance of assuring that MR images used for radiotherapy treatment planning are properly distortion-corrected.

Indexed as

Brain NeoplasmsMagnetic Resonance ImagingRadiosurgeryAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRadiotherapy Planning, Computer-AssistedRetrospective StudiesTreatment Outcome

Identifiers

PMID40097510
PMCPMC11914157

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.