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How long after resection for brain metastasis do you wait to request a radiation planning MRI?

Can this be done right away or do you wait for the cavity to involute before you plan postop SRS to cavity?
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What dose fractionation do you use for a 2.5 cm post-op cavity for brain mets?

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4 Answers
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Radiation Oncology · Turville Bay MRI & Radiation Oncology Center
Answered on

This is a good question, and I agree with the sentiments above. I think there are two competing issues here--1) evolution of the cavity and 2) regrowth of microscopic disease.

While intuitively, one might think that waiting longer might allow the brain to normalize and the cavity to shrink, our data ...

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Radiation Oncology · Columbia University Irving Medical Center
Answered on

Assuming this is a patient with one or limited brain metastases and the resection is complete (gross total resection), I would consider obtaining an MRI within 30 days. For large resection cavities, there's data showing cavity reduction >= 1 month (Shah et al., PMID 27222693) which may help reduce S...

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Radiation Oncology · Bon Secours Mercy Health
Answered on

Unfortunately, there is not a hard & fast answer to this question. There are some general parameters but each patient might be different. The key is to obtain the MRI before you have obliteration of the cavity. My general rule of thumb is around 10-14 days post surgery. In my own experience, it is t...

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Radiation Oncology · Clearview Cancer Institute
Answered on

I have always approached this question considering 3 factors to determine the timing of post op cavity planning MRI, CT sim, and starting treatment to brain met resection cavities. We deliver fractionated SRS for post op cavities (9 Gy x 3 or 6 Gy x 5). The timing of the planning MRI obviously impac...

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