Application of three-dimensional turbo spin-echo (SPACE) sequence in target delineation for stereotactic radiotherapy of brain metastases
10.3760/cma.j.cn113030-20250402-00130
- VernacularTitle:三维快速自旋回波序列在脑转移瘤SRT靶区勾画中的应用
- Author:
Danhong DING
1
;
Junyao XU
;
Nan MENG
;
Xiangyue LIU
;
Tiantian CUI
;
Lingguang MENG
;
Zhaoyang LOU
;
Hong GE
;
Bing LI
Author Information
1. 郑州大学附属肿瘤医院&河南省肿瘤医院放疗科，郑州 450008
- Publication Type:Journal Article
- Keywords:
Neoplasm metastasis, brain;
Three-dimensional fast spin echo sequence;
Magnetic resonance imaging;
Stereotactic radiotherapy
- From:
Chinese Journal of Radiation Oncology
2025;34(11):1132-1138
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the detection capability of the contrast-enhanced three-dimensional turbo spin-echo (CE-SPACE) sequence for brain metastases (BM), aiming to provide evidence for precise target delineation in stereotactic radiotherapy (SRT).Methods:A total of 123 BM patients who received radiotherapy at the Affiliated Cancer Hospital of Zhengzhou University from May to November 2024 were enrolled. All patients underwent contrast-enhanced (CE) MRI and CT scans in the same treatment position, with images rigidly registered in the Eclipse planning system. Two experienced radiation oncologists independently delineated BM lesions on CE-MPRAGE and CE-SPACE sequences in a blinded manner. Patients were divided into the delayed group (10 min, n=61) and a priority group (5 min, n=62) based on the time interval between gadolinium injection and CE-SPACE acquisition. The non-parametric Wilcoxon rank-sum test was used to compare the lesion counts and volume differences between the two imaging sequences. Point-biserial correlation analysis was performed to assess the correlation between the additional lesions identified by CE-SPACE and lesion volume. Results:The overall analysis demonstrated that CE-SPACE detected 421 BM lesions, achieving an 8.2% higher detection rate than CE-MPRAGE ( Z=3.78, P<0.001). In terms of lesion volume, the median BM lesions volume identified by CE-SPACE [0.30(0.07,1.53)cm 3] was 8.7% larger than that by CE-MPRAGE [0.23 (0.04, 1.34) cm 3] ( Z=12.88, P<0.001). CE-SPACE demonstrated superior sensitivity for lesions ≤ 0.06 cm3, with negative correlation between the number of additional lesions detected and lesion volume ( r=-0.104, P=0.034). Subgroup analysis revealed that in the delayed group, CE-SPACE detected significantly more lesions [median 2 (1, 3.5) vs. 2 (1, 3), P=0.002] and larger volumes [0.39 (0.08, 2.24) cm3 vs. 0.29 (0.05, 1.99) cm3, P<0.001] than CE-MPRAGE. In the priority group, CE-SPACE detected significantly larger lesion volumes [0.55 (0.09, 2.06) cm3 vs. 0.45 (0.08, 1.88) cm3, P<0.001], but no significant difference was observed in lesion counts between two sequences ( P=0.059). Conclusions:Three-dimensional CE-SPACE sequence offers superior detection sensitivity for small BM (≤ 0.06 cm3), providing crucial guidance for accurate target delineation in SRT.
