Optimizing contrast-enhanced magnetic resonance imaging characterization of brain metastases: Relevance to stereotactic radiosurgery

Anzalone N, Essig M, Lee SK, Dörfler A, Ganslandt O, Combs SE, Picozzi P (2013)

Publication Type: Journal article, Review article

Publication year: 2013

Journal

Neurosurgery Oxford University Press (OUP)

Book Volume: 72

Pages Range: 691-701

Journal Issue: 5

DOI: 10.1227/NEU.0b013e3182889ddf

Abstract

Intracranial metastases are the most common form of intra-axial brain tumor. Management approaches to brain metastases include surgical resection, whole-brain radiotherapy, and stereotactic radiosurgery (SRS). The management approach that is selected is based typically on algorithms that incorporate the number, size, and location of lesions. SRS is the treatment of choice when metastases detected on imaging are few (maximum, 3-5) and/or of small size (≤30 mm) and offers the advantages of noninvasiveness and the ability to treat inaccessible lesions compared with surgical resection. Contrast-enhanced magnetic resonance imaging (MRI) is the standard imaging technique for determining the number, size, and location of metastatic lesions. In SRS, the capability of MRI to delineate lesion borders precisely in 3 dimensions helps reduce recurrence rates and minimize radiation necrosis in surrounding tissue. Optimization of the MRI protocol, including selection of the appropriate gadolinium-based contrast agent (GBCA), is paramount for accurate lesion imaging. GBCAs differ in their safety, tolerability, and efficacy because of their diverse physicochemical properties. Gadobutrol and gadobenate dimeglumine are high-relaxivity GBCAs that demonstrate superior efficacy for imaging metastatic lesions compared with other GBCAs, whereas gadobutrol additionally provides macrocyclic stability. This article reviews recent comparative trials of GBCAs and discusses their relevance for optimizing MRI protocols in the management of brain metastases, with particular relevance to SRS. ABBREVIATIONS:: CNR, contrast-to-noise ratioCNS, central nervous systemGBCA, gadolinium-based contrast agentNSF, nephrogenic systemic fibrosisSRS, stereotactic radiosurgeryWBRT, whole-brain radiotherapy. © 2013 by the Congress of Neurological Surgeons.

Authors with CRIS profile

Arnd Dörfler Department of Neuroradiology Oliver Thomas Ganslandt Lehrstuhl für Neurochirurgie

Involved external institutions

Ospedale San Raffaele (früher: Centro San Raffaele del Monte Tabor Foundation) IT Italy (IT) Yonsei University KR Korea, Republic of (KR) Universitätsklinikum Heidelberg DE Germany (DE)

How to cite

APA:

Anzalone, N., Essig, M., Lee, S.-K., Dörfler, A., Ganslandt, O., Combs, S.E., & Picozzi, P. (2013). Optimizing contrast-enhanced magnetic resonance imaging characterization of brain metastases: Relevance to stereotactic radiosurgery. Neurosurgery, 72(5), 691-701. https://doi.org/10.1227/NEU.0b013e3182889ddf

MLA:

Anzalone, Nicoletta, et al. "Optimizing contrast-enhanced magnetic resonance imaging characterization of brain metastases: Relevance to stereotactic radiosurgery." Neurosurgery 72.5 (2013): 691-701.

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