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DOI: 10.1148/radiol.2281020298
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Assessment of Brain Metastases with Dynamic Susceptibility-weighted Contrast-enhanced MR Imaging: Initial Results1

Marco Essig, MD, Michael Waschkies, MD, Frederik Wenz, MD, J. Debus, MD, PhD, H. R. Hentrich, MD and M. V. Knopp, MD

1 From the Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany (M.E., M.W., F.W., J.D., M.V.K.), and Bracco Byk-Gulden, Konstanz, Germany (H.R.H.). Received April 9, 2002; revision requested June 5; final revision received November 5; accepted December 10. Address correspondence to M. E. (e-mail: m.essig@dkfz-heidelberg.de).



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  		Figure 1. Patient 9. Therapy responder. MR images obtained in a 59-year-old female patient with left frontal melanoma metastasis. At 6-week follow-up, the tumor shows a 142% volume increase (arrows), while the regional CBV (rCBV) has a decrease of 85%, indicating a tumor response. Because of patient’s agitation, the head was positioned obliquely during the examination. At 3-month follow-up, the volume decreased, with only a mild increase of the regional CBV. At 6-month follow-up, the tumor volume continued to remain stable. The disease was graded as stable.

 


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  		Figure 2. Graph depicts changes in the regional CBV (rCBV) in eight patients with tumor response. Displayed are the percentages of regional CBV changes in patients with tumor response (pronounced and minor response). In all but one patient, the regional CBV decreased at 6-week and 3-month follow-up. Symbols represent individual patients.

 


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  		Figure 3. Patient 16. Therapy nonresponder. MR images obtained in a 52-year-old male patient with right occipital renal cell carcinoma metastasis. The patient had a decrease of the tumor volume at 6-week follow-up, with a subsequent tumor volume increase at 3-month follow-up (arrows). The regional CBV (rCBV) values were elevated at 6-week follow-up, indicating tumor progression.

 


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  		Figure 4. Graph depicts changes in the regional CBV (rCBV) in four patients with tumor nonresponse. Displayed are the percentages of regional CBV changes in patients with tumors that did not respond to treatment (nonresponders). At 6-week follow-up, two patients each had a decrease and an increase in the regional CBV, while at 3-month follow-up, three of four patients had an increase in the regional CBV values. Symbols represent individual patients.

 




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