Distribution of brain metastases: low-risk metastasis areas may be avoided when treating with whole-brain radiotherapy
Abstract Objective Previous work has demonstrated that metastases are not uniformly distributed across the brain. This study aims to determine there are low-risk brain metastasis (BM) areas that may be avoided during whole-brain radiotherapy (WBRT) to reduce neurocognitive toxicity. Methods Clinical...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-04-01
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| Series: | Cancer Imaging |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40644-020-00309-y |
| _version_ | 1818414063482306560 |
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| author | Binwei Lin Dan Huang Xiyue Yang Yu Zhang Feng Gang Xiao Bo Du |
| author_facet | Binwei Lin Dan Huang Xiyue Yang Yu Zhang Feng Gang Xiao Bo Du |
| author_sort | Binwei Lin |
| collection | DOAJ |
| description | Abstract Objective Previous work has demonstrated that metastases are not uniformly distributed across the brain. This study aims to determine there are low-risk brain metastasis (BM) areas that may be avoided during whole-brain radiotherapy (WBRT) to reduce neurocognitive toxicity. Methods Clinical and magnetic resonance imaging (MRI) data of 991 metastases in 192 patients with advanced cancer were analyzed retrospectively. Eleven anatomically defined regions of interest (ROIs) were contoured, and the locations of the BMs were recorded. Using the same definition, ROIs were contoured in 20 healthy volunteers.The proportions of patients with BMs in different ROIs, proportion of BMs, and proportion of different ROI volumes relative to the total volume were calculated. Results The proportion of observed BMs was lower than expected in the brainstem, insula, diencephalon and internal structures, corpus callosum, and pituitary gland. The proportion of BMs was significantly higher than expected in the parietal lobe, occipital lobe, and cerebellum. For those patients with single BM, there was very low rate of low-risk ROIs involvement (0%), with 2–4 BMs, 6–13% of the patients had low-risk ROIs involvement, with ≥5 BMs, significant (> 30%) of the patients had low-risk ROIs involvement. Conclusion The brainstem, insula, diencephalon and internal structures, corpus callosum, and pituitary gland demonstrate low risk for metastatic involvement. Involvement of low risk areas occurs in patients with more than 1 BM. |
| first_indexed | 2024-12-14T11:13:08Z |
| format | Article |
| id | doaj.art-f3ac24254321428bbb895d833eb64486 |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-12-14T11:13:08Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-f3ac24254321428bbb895d833eb644862022-12-21T23:04:12ZengBMCCancer Imaging1470-73302020-04-012011710.1186/s40644-020-00309-yDistribution of brain metastases: low-risk metastasis areas may be avoided when treating with whole-brain radiotherapyBinwei Lin0Dan Huang1Xiyue Yang2Yu Zhang3Feng Gang4Xiao Bo Du5Department of Oncology, Mianyang Central HospitalRadiology Department, Mianyang Central HospitalDepartment of Oncology, Affiliated Hospital of North Sichuan Medical CollegeDepartment of Oncology, Mianyang Central HospitalDepartment of Oncology, Mianyang Central HospitalDepartment of Oncology, Mianyang Central HospitalAbstract Objective Previous work has demonstrated that metastases are not uniformly distributed across the brain. This study aims to determine there are low-risk brain metastasis (BM) areas that may be avoided during whole-brain radiotherapy (WBRT) to reduce neurocognitive toxicity. Methods Clinical and magnetic resonance imaging (MRI) data of 991 metastases in 192 patients with advanced cancer were analyzed retrospectively. Eleven anatomically defined regions of interest (ROIs) were contoured, and the locations of the BMs were recorded. Using the same definition, ROIs were contoured in 20 healthy volunteers.The proportions of patients with BMs in different ROIs, proportion of BMs, and proportion of different ROI volumes relative to the total volume were calculated. Results The proportion of observed BMs was lower than expected in the brainstem, insula, diencephalon and internal structures, corpus callosum, and pituitary gland. The proportion of BMs was significantly higher than expected in the parietal lobe, occipital lobe, and cerebellum. For those patients with single BM, there was very low rate of low-risk ROIs involvement (0%), with 2–4 BMs, 6–13% of the patients had low-risk ROIs involvement, with ≥5 BMs, significant (> 30%) of the patients had low-risk ROIs involvement. Conclusion The brainstem, insula, diencephalon and internal structures, corpus callosum, and pituitary gland demonstrate low risk for metastatic involvement. Involvement of low risk areas occurs in patients with more than 1 BM.http://link.springer.com/article/10.1186/s40644-020-00309-yBrain metastasisWhole-brain radiotherapyDistribution |
| spellingShingle | Binwei Lin Dan Huang Xiyue Yang Yu Zhang Feng Gang Xiao Bo Du Distribution of brain metastases: low-risk metastasis areas may be avoided when treating with whole-brain radiotherapy Cancer Imaging Brain metastasis Whole-brain radiotherapy Distribution |
| title | Distribution of brain metastases: low-risk metastasis areas may be avoided when treating with whole-brain radiotherapy |
| title_full | Distribution of brain metastases: low-risk metastasis areas may be avoided when treating with whole-brain radiotherapy |
| title_fullStr | Distribution of brain metastases: low-risk metastasis areas may be avoided when treating with whole-brain radiotherapy |
| title_full_unstemmed | Distribution of brain metastases: low-risk metastasis areas may be avoided when treating with whole-brain radiotherapy |
| title_short | Distribution of brain metastases: low-risk metastasis areas may be avoided when treating with whole-brain radiotherapy |
| title_sort | distribution of brain metastases low risk metastasis areas may be avoided when treating with whole brain radiotherapy |
| topic | Brain metastasis Whole-brain radiotherapy Distribution |
| url | http://link.springer.com/article/10.1186/s40644-020-00309-y |
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