Abstract：
OBJECTIVE: The Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) working group proposed a guide for treatment responses for BMs by utilizing the longest diameter; however, despite recognizing that many patients with BMs have sub-centimeter lesions, the group referred to these lesions as unmeasurable due to issues with repeatability and interpretation. In light of RANO-BM recommendations, we aimed to correlate linear and volumetric measurements in sub-centimeter BMs on contrast-enhanced MRI using intelligent automation software.
METHODS: In this retrospective study, patients with BMs scanned with MRI between January 1, 2018, and December 31, 2021, were screened. Inclusion criteria were: (1) at least one sub-centimeter BM with an integer millimeter-longest diameter was noted in the MRI report; (2) patients were a minimum of 18 years of age; (3) patients with available pre-treatment three-dimensional T1-weighted spoiled gradient-echo MRI scan. The screening was terminated when there were 20 lesions in each group. Lesion volumes were measured with the help of intelligent automation software Jazz (AI Medical, Zollikon, Switzerland) by two readers. The Kruskal-Wallis test was used to compare volumetric differences.
RESULTS: Our study included 180 patients. The agreement for volumetric measurements was excellent between the two readers. The volumes of the following groups were not significantly different: 1-2 mm, 1-3 mm, 1-4 mm, 2-3 mm, 2-4 mm, 3-4 mm, 3-5 mm, 4-5 mm, 5-6 mm, 5-7 mm, 6-7 mm, 6-8 mm, 6-9 mm, 7-8 mm, 7-9 mm, 8-9 mm.
CONCLUSIONS: Our findings indicate that the largest diameter of a lesion may not accurately represent its volume. Additional research is required to determine which method is superior for measuring radiologic response to therapy and which parameter correlates best with clinical improvement or deterioration.
METHODS: In this retrospective study, patients with BMs scanned with MRI between January 1, 2018, and December 31, 2021, were screened. Inclusion criteria were: (1) at least one sub-centimeter BM with an integer millimeter-longest diameter was noted in the MRI report; (2) patients were a minimum of 18 years of age; (3) patients with available pre-treatment three-dimensional T1-weighted spoiled gradient-echo MRI scan. The screening was terminated when there were 20 lesions in each group. Lesion volumes were measured with the help of intelligent automation software Jazz (AI Medical, Zollikon, Switzerland) by two readers. The Kruskal-Wallis test was used to compare volumetric differences.
RESULTS: Our study included 180 patients. The agreement for volumetric measurements was excellent between the two readers. The volumes of the following groups were not significantly different: 1-2 mm, 1-3 mm, 1-4 mm, 2-3 mm, 2-4 mm, 3-4 mm, 3-5 mm, 4-5 mm, 5-6 mm, 5-7 mm, 6-7 mm, 6-8 mm, 6-9 mm, 7-8 mm, 7-9 mm, 8-9 mm.
CONCLUSIONS: Our findings indicate that the largest diameter of a lesion may not accurately represent its volume. Additional research is required to determine which method is superior for measuring radiologic response to therapy and which parameter correlates best with clinical improvement or deterioration.
摘要：
目的：神经肿瘤学脑转移反应评估（RANO-BM）工作组提出了利用最长直径对BM的治疗反应指南；然而，尽管认识到许多BMs患者有亚厘米病变，由于重复性和解释方面的问题,研究组认为这些病变是无法测量的.根据RANO-BM的建议，我们的目标是使用智能自动化软件在对比增强MRI上对亚厘米BM的线性和体积测量进行关联。
方法：在这项回顾性研究中，我们对2018年1月1日至2021年12月31日期间接受MRI扫描的BMs患者进行了筛查.纳入标准为：（1）在MRI报告中注意到至少一个亚厘米BM，其直径为整数毫米长；（2）患者年龄最小为18岁；（3）治疗前可进行三维T1加权破坏梯度回波MRI扫描的患者。当每组有20个病变时终止筛查。借助智能自动化软件Jazz(AIMedical，Zollikon,瑞士）两位读者。使用Kruskal-Wallis检验比较体积差异。
结果：我们的研究包括180名患者。两位读者之间体积测量的一致性非常好。以下各组的体积没有显着差异：1-2毫米，1-3毫米,1-4毫米，2-3毫米，2-4毫米，3-4毫米，3-5毫米，4-5毫米，5-6毫米，5-7毫米，6-7毫米，6-8毫米，6-9毫米，7-8毫米，7-9毫米，8-9毫米。
结论：我们的研究结果表明，病变的最大直径可能无法准确代表其体积。需要进一步的研究来确定哪种方法更适合测量放射学对治疗的反应，以及哪种参数与临床改善或恶化最相关。
方法：在这项回顾性研究中，我们对2018年1月1日至2021年12月31日期间接受MRI扫描的BMs患者进行了筛查.纳入标准为：（1）在MRI报告中注意到至少一个亚厘米BM，其直径为整数毫米长；（2）患者年龄最小为18岁；（3）治疗前可进行三维T1加权破坏梯度回波MRI扫描的患者。当每组有20个病变时终止筛查。借助智能自动化软件Jazz(AIMedical，Zollikon,瑞士）两位读者。使用Kruskal-Wallis检验比较体积差异。
结果：我们的研究包括180名患者。两位读者之间体积测量的一致性非常好。以下各组的体积没有显着差异：1-2毫米，1-3毫米,1-4毫米，2-3毫米，2-4毫米，3-4毫米，3-5毫米，4-5毫米，5-6毫米，5-7毫米，6-7毫米，6-8毫米，6-9毫米，7-8毫米，7-9毫米，8-9毫米。
结论：我们的研究结果表明，病变的最大直径可能无法准确代表其体积。需要进一步的研究来确定哪种方法更适合测量放射学对治疗的反应，以及哪种参数与临床改善或恶化最相关。
