Stereotactic radiosurgery of brain metastases can cause pseudoprogression. In this study, we use Vessel Architectural Imaging, based on dual echo DSC, to investigate the course of vascular function of brain metastases, both prior to and after pseudoprogression have occurred. Our results show that pseudoprogressing metastases were characterized by underperfused and oxygen-deprived tissue, and micro- and macrovessel pruning in the peritumoral regions. This was in contrast to peritumoral regions of responding metastases as well as normal-appearing brain tissue.
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