Effect of MRI-based semiautomatic size-assessment in cerebral metastases on the RANO-BM classification



Evaluation of a semiautomatic software algorithm for magnetic resonance imaging (MRI)-based assessment of cerebral metastases in cancer patients.

Material and Methods

Brain metastases (n = 131) in 38 patients, assessed by contrast-enhanced MRI, were retrospectively evaluated at two timepoints (baseline, follow-up) by two experienced neuroradiologists in a blinded manner. The response assessment in neuro-oncology (RANO) criteria for brain metastases (RANO-BM) were applied by means of a software (autoRANO-BM) as well as manually (manRANO-BM) at an interval of 3 weeks.


The average diameter of metastases was 12.03 mm (SD ± 6.66 mm) for manRANO-BM and 13.97 mm (SD ± 7.76 mm) for autoRANO-BM. Diameter figures were higher when using semiautomatic measurements (median = 11.8 mm) as compared to the manual ones (median = 10.2 mm; p = 0.000). Correlation coefficients for intra-observer variability were 0.993 (autoRANO-BM) and 0.979 (manRANO-BM). The interobserver variability (R1/R2) was 0.936/0.965 for manRANO-BM and 0.989/0.998 for autoRANO-BM. A total of 19 lesions (15%) were classified differently when using semiautomatic measurements. In 14 cases with suspected disease progression by manRANO-BM a stable course was found according to autoRANO-BM.


Computerized measuring techniques can aid in the assessment of cerebral metastases by reducing examiner-dependent effects and may consequently result in a different classification according to RANO-BM criteria.

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Corresponding author

Correspondence to Hans-Christian Bauknecht.

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Conflict of interest

H.-C. Bauknecht, R. Klingebiel, P. Hein, C. Wolf, L. Bornemann, E. Siebert and G. Bohner declare that they have no competing interests.

Ethical standards

This study has been approved by the ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Bauknecht, H., Klingebiel, R., Hein, P. et al. Effect of MRI-based semiautomatic size-assessment in cerebral metastases on the RANO-BM classification. Clin Neuroradiol 30, 263–270 (2020). https://doi.org/10.1007/s00062-019-00785-1

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  • Cerebral metastases
  • Semiautomatic measurement
  • Response group
  • Radiooncological imaging