立体定向放射治疗是治疗脑转移瘤 (BM) 少于 5 个的患者的首选治疗方法。然而，有些病变在照射后会复发。本研究的目的是确定失败风险较高的患者，这有助于调整治疗和预防复发。在这项回顾性多中心研究中，我们分析了一组可解释的形态学特征的预测意义，这些特征源自对比-使用 Kaplan-Meier 分析增强 (CE) T1 加权 MR 图像作为成像生物标志物。研究的特征集包括总体积和坏死体积、表面规则性和 CE 边缘宽度。此外，我们评估了其他非形态学变量并进行了多变量 Cox 分析。 总共纳入了 128 名接受立体定向放射治疗的患者（中位年龄 61 [31-95]，64 名男性和 64 名女性）的 183 个病灶（57% 单次放疗，43% ％分割放射治疗）。诊断时测量的研究变量均未发现具有预后价值。然而，治疗后第一次随访时测量的总体积和坏死体积以及 CE 边缘宽度以及由于照射引起的体积变化可以用作复发的成像生物标志物。通过将治疗前后肿瘤体积的变化与是否存在坏死相结合来实现最佳分类（p <  < 0.001）。本研究证明了从脑部照射后的常规临床 MR 图像中提取的可解释形态特征的预后意义转移，为个性化治疗策略提供有价值的见解。© 2024。作者。

Stereotactic radiotherapy is the preferred treatment for managing patients with fewer than five brain metastases (BMs). However, some lesions recur after irradiation. The purpose of this study was to identify patients who are at a higher risk of failure, which can help in adjusting treatments and preventing recurrence.In this retrospective multicenter study, we analyzed the predictive significance of a set of interpretable morphological features derived from contrast-enhanced (CE) T1-weighted MR images as imaging biomarkers using Kaplan-Meier analysis. The feature sets studied included the total and necrotic volumes, the surface regularity and the CE rim width. Additionally, we evaluated other nonmorphological variables and performed multivariate Cox analysis.A total of 183 lesions in 128 patients were included (median age 61 [31-95], 64 men and 64 women) treated with stereotactic radiotherapy (57% single fraction, 43% fractionated radiotherapy). None of the studied variables measured at diagnosis were found to have prognostic value. However, the total and necrotic volumes and the CE rim width measured at the first follow-up after treatment and the change in volume due to irradiation can be used as imaging biomarkers for recurrence. The optimal classification was achieved by combining the changes in tumor volume before and after treatment with the presence or absence of necrosis (p <  < 0.001).This study demonstrated the prognostic significance of interpretable morphological features extracted from routine clinical MR images following irradiation in brain metastases, offering valuable insights for personalized treatment strategies.© 2024. The Author(s).