Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 17;15(1):9077.
doi: 10.1038/s41598-025-93255-3.

MRI distortion correction is associated with improved local control in stereotactic radiotherapy for brain metastases

Daniel Höfler  1   2   3 , Johanna Grigo  4   5 , Hadi Siavosch  4   5 , Marc Saake  6   5 , Manuel Alexander Schmidt  7   5   8 , Thomas Weissmann  4   5   8 , Philipp Schubert  4   5   8 , Raphaela Voigt  4   5 , Sebastian Lettmaier  4   5 , Sabine Semrau  4   5   8 , Arnd Dörfler  7   5   8 , Michael Uder  6   5   8 , Christoph Bert  4   5   8 , Rainer Fietkau  4   5   8 , Florian Putz  4   5   8
Affiliations

MRI distortion correction is associated with improved local control in stereotactic radiotherapy for brain metastases

Daniel Höfler et al. Sci Rep. .

Abstract

Distortions in brain MRI caused by gradient nonlinearities may reach several millimeters, thus distortion correction is strongly recommended for radiotherapy treatment planning. However, the significance of MRI distortion correction on actual clinical outcomes has not been described yet. Therefore, we investigated the impact of planning MRI distortion correction on subsequent local control in a historic series of 419 brain metastases in 189 patients treated with stereotactic radiotherapy between 01/2003 and 04/2015. Local control was evaluated using a volumetric extension of the RANO-BM criteria. The predictive significance of distortion correction was assessed using competing risk analysis. In this cohort, 2D distortion-corrected MRIs had been used for treatment planning in 52.5% (220/419) of lesions, while uncorrected MRIs had been employed in 47.5% (199/419) of metastases. 2D distortion correction was associated with improved local control (Cumulative incidence of local progression at 12 months: 14.3% vs. 21.2% and at 24 months: 18.7% vs. 28.6%, p = 0.038). In multivariate analysis, adjusting for histology, baseline tumor volume, interval between MRI and treatment delivery, year of planning MRI, biologically effective dose and adjuvant Whole-brain radiotherapy, use of distortion correction remained significantly associated with improved local control (HR 0.55, p = 0.020). This is the first study to clinically evaluate the impact of MRI gradient nonlinearity distortion correction on local control in stereotactic radiotherapy for brain metastases. In this historic series, we found significantly higher local control when using 2D corrected vs. uncorrected MRI studies for treatment planning. These results stress the importance of assuring that MR images used for radiotherapy treatment planning are properly distortion-corrected.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: Speaker fees from Siemens Healthineers (unrelated to this work): DH, MS, PS, FP. The other authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Exemplary cases from the uncorrected subgroup with considerable distortions. Uncorrected MR images are shown overlaid by uncorrected and corrected GTV contours. Red contours depict the uncorrected GTV perimeter, green contours display the corrected tumor outline after 3D distortion correction for gradient nonlinearity-induced distortions.
Fig. 2
Fig. 2
Cumulative incidence of local progression in brain metastases, in which treatment planning was based on a 2D distortion-corrected MRI (“2D”, blue, n = 220) or an uncorrected MRI dataset (“ND”, red, n = 199).
Fig. 3
Fig. 3
Cumulative incidence of local progression in the subset of melanoma brain metastases for treatment planning on 2D distortion corrected (“2D”, blue, n = 80) and uncorrected (“ND”, red, n = 98) MRI datasets.
Fig. 4
Fig. 4
Cumulative incidence of local tumor progression according to the distortion correction status shown separately for peripheral (A) and centrally located lesions (B). increased difference between 2D distortion-corrected (“2D”, blue) and uncorrected MRI datasets (“ND”, red) in metastases with peripheral location.
Fig. 5
Fig. 5
Overall survival for the distortion-corrected (“2D”, blue, n = 220) and uncorrected (“ND”, red, n = 199) subgroup.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Tabouret, E. et al. Recent trends in epidemiology of brain metastases: an overview. Anticancer Res.32(11), 4655–4662 (2012). - PubMed
    1. Soffietti, R. et al. Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European association of neuro-oncology (EANO). Neuro Oncol.19(2), 162–174 (2017). - PMC - PubMed
    1. Gaudy-Marqueste, C. et al. Survival of melanoma patients treated with targeted therapy and immunotherapy after systematic upfront control of brain metastases by radiosurgery. Eur. J. Cancer84, 44–54 (2017). - PubMed
    1. Johung, K. L. et al. Extended survival and prognostic factors for patients with ALK-rearranged non-small-cell lung cancer and brain metastasis. J. Clin. Oncol.34(2), 123–129 (2016). - PMC - PubMed
    1. Steinmann, D. et al. Quality of life in patients with limited (1–3) brain metastases undergoing stereotactic or whole brain radiotherapy: A prospective study of the DEGRO QoL working group. Strahlenther. Onkol.196(1), 48–57 (2020). - PubMed

LinkOut - more resources