Neuroimaging and Stereotactic Body Radiation Therapy (SBRT) for Spine Metastasis

Majid Khan, Rahul Garg, Chengcheng Gui, Young Lee, Arjun Sahgal, Mahmud Mossa-Basha, Nina Mayr, Simon Lo, Kristin Redmond

Research output: Contribution to journalReview articlepeer-review

Abstract

Historically, management options for spinal metastases include surgery for stabilization and decompression and/or external beam radiation therapy (EBRT). EBRT is palliative in nature, as it lacks accurate targeting such that the prescribed radiation doses must be limited in order to maintain safety. Modern advancement in imaging and radiotherapy technology have facilitated the development of stereotactic body radiation therapy (SBRT), which provides increased targeted precision for radiation delivery to tumors resulting in lower overall toxicity, particularly to regional structures such as the spinal cord and esophagus, while delivering higher, more effective, and radically ablative radiation doses.Over the past decade, SBRT has been increasingly utilized as a method of treating spinal metastases either as the primary modality or following surgical intervention in both de novo and reirradiation setting. Numerous studies suggest that SBRT is associated with an 80% to 90% rate of 1-year local control across clinical scenarios. For example, studies of SBRT as the primary treatment modality suggest long-term local control rate of 80% to 95% for spinal metastases. Similarly, SBRT in the adjuvant setting following surgery is associated with local control rates ranging from 70% to 100%. Furthermore, because SBRT allows for lower dose to the spinal cord, it has also been used in patients who have had prior radiation therapy, with studies showing 66% to 93% local control in this scenario.

Original languageEnglish (US)
Pages (from-to)85-96
Number of pages12
JournalTopics in Magnetic Resonance Imaging
Volume28
Issue number2
DOIs
StatePublished - Apr 1 2019

Keywords

  • computed tomography
  • diffusion-weighted imaging
  • dynamic contrast-enhanced MRI
  • external beam radiation therapy
  • spine response assessment in neuro-oncology
  • stereotactic body radiation therapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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