Figure 5

Analysing the brain-metastasis interface. Metastases could be stratified by the sharpness of the tumor border on ADC maps. Panel A. demonstrates a lesion with a high ATC or “ADC transition coefficient” implying a sharp border. This type of metastasis tended to have a high cellularity (H & E section x200). Panel B. demonstrates a case which looks superficially similar on postcontrast T1-weighted sequence but actually has a much more diffuse border on the ADC map and hence a low ATC, with lower cellularity. C. These metastases differ in their outcomes and the cases with a high ATC (> median) and therefore a sharp boundary had a shorter overall survival 6.8 months (95% CI 5.3 – 8.4) as compared to those with a low ATC and hence diffuse boundary (11.2 months, 95% CI 8.3 – 14.0, Log rank Chi-Square = 4.19, p = 0.041). This effect was significant even in multivariate analysis incorporating traditional clinical predictors.