Qualitative Dynamic Contrast-Enhanced MRI Time–Intensity Curve Analysis for Differentiating Non-Progressive Treatment-Related Changes from Tumor Progression After Stereotactic Radiotherapy for Brain Metastases
8 affiliations
- 1Department of Neuroscience, Mental Health and Sensory Organs—NESMOS, Sapienza University of Rome, 00189 Rome, Italy
- 2Neuroradiology Department, Azienda Ospedaliera Sant’Andrea, 00189 Rome, Italy
- 3Neuroradiology Department, Azienda Ospedaliera San Camillo-Forlanini, 00152 Rome, Italy
- 4Radiotherapy Department, Azienda Ospedaliera Sant’Andrea, 00189 Rome, Italy
- 5Local Sanitary Hospital Rome 5, 00019 Tivoli, Italy
- 6Radiology Department, G.B. Grassi, 00192 Ostia, Italy
- 7Radiotherapy Department, Campus Bio Medico University Hospital, 00128 Rome, Italy
- 8Campus Bio Medico University Hospital, 00128 Rome, Italy
Abstract
Background: This exploratory study assessed whether qualitative dynamic contrast-enhanced MRI (DCE-MRI) time–intensity curves (TICs) differentiate non-progressive treatment-related changes (NPTRC) from tumor progression after stereotactic radiotherapy for brain metastases. Methods: Thirty-two patients with 51 treated lesions underwent DCE-MRI. Five neuroradiologists independently delineated a volume of interest and classified the resulting TIC as Type A–D. Longitudinal clinical and MRI follow-up provided the reference outcome, which was recorded before the TIC framework was finalized. An A/B versus C/D grouping was evaluated as a secondary exploratory analysis. Results: Thirty-five lesions were classified as NPTRC and 16 as tumor progression. All 17 Type A lesions were NPTRC, whereas all 13 Type C/D lesions showed progression. Type B was observed in 21 of 51 lesions (41.2%), including 18 NPTRC and 3 progressive lesions, representing a substantial indeterminate subgroup. The exploratory A/B versus C/D grouping yielded 81.3% sensitivity and 100% specificity. The ordinal TIC analysis yielded an AUC of 0.952. Interobserver agreement was high within the present reader group (Fleiss’ κ = 0.889). Conclusions: Type A was associated with NPTRC, Types C/D were associated with progression, and Type B represented an indeterminate pattern. These descriptive findings require independent validation before clinical use.
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BibTeX
@article{romano2026qualitative,
title = {{Qualitative Dynamic Contrast-Enhanced MRI Time–Intensity Curve Analysis for Differentiating Non-Progressive Treatment-Related Changes from Tumor Progression After Stereotactic Radiotherapy for Brain Metastases}},
author = {Andrea Romano and Giulia Moltoni and Anna Maria Ascolese and Emanuela Parri and Cristiana Monopoli and Paolo Matteucci and Carlo Greco and Lucrezia Toppi and Sara Reina and Sara Ramella and Alessandro Bozzao},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18203344},
url = {https://www.mdpi.com/2072-6694/18/20/3344},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Qualitative Dynamic Contrast-Enhanced MRI Time–Intensity Curve Analysis for Differentiating Non-Progressive Treatment-Related Changes from Tumor Progression After Stereotactic Radiotherapy for Brain Metastases
AU - Andrea Romano
AU - Giulia Moltoni
AU - Anna Maria Ascolese
AU - Emanuela Parri
AU - Cristiana Monopoli
AU - Paolo Matteucci
AU - Carlo Greco
AU - Lucrezia Toppi
AU - Sara Reina
AU - Sara Ramella
AU - Alessandro Bozzao
PY - 2026
DA - 2026/10/01
JO - Cancers
DO - 10.3390/cancers18203344
UR - https://www.mdpi.com/2072-6694/18/20/3344
AB - Background: This exploratory study assessed whether qualitative dynamic contrast-enhanced MRI (DCE-MRI) time–intensity curves (TICs) differentiate non-progressive treatment-related changes (NPTRC) from tumor progression after stereotactic radiotherapy for brain metastases. Methods: Thirty-two patients with 51 treated lesions underwent DCE-MRI. Five neuroradiologists independently delineated a volume of interest and classified the resulting TIC as Type A–D. Longitudinal clinical and MRI follow-up provided the reference outcome, which was recorded before the TIC framework was finalized. An A/B versus C/D grouping was evaluated as a secondary exploratory analysis. Results: Thirty-five lesions were classified as NPTRC and 16 as tumor progression. All 17 Type A lesions were NPTRC, whereas all 13 Type C/D lesions showed progression. Type B was observed in 21 of 51 lesions (41.2%), including 18 NPTRC and 3 progressive lesions, representing a substantial indeterminate subgroup. The exploratory A/B versus C/D grouping yielded 81.3% sensitivity and 100% specificity. The ordinal TIC analysis yielded an AUC of 0.952. Interobserver agreement was high within the present reader group (Fleiss’ κ = 0.889). Conclusions: Type A was associated with NPTRC, Types C/D were associated with progression, and Type B represented an indeterminate pattern. These descriptive findings require independent validation before clinical use.
SN - 2072-6694
ER -