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Detecting Brain Metastases in Patients With Lung Cancer: Comparison of Imaging Modalities

By: Joseph Fanelli
Posted: Thursday, August 29, 2019

According to findings presented in the European Journal of Cancer, using a magnetic resonance imaging (MRI) is reportedly more effective in detecting brain metastases than dynamic contrast enhanced–computed tomography (CE-CT) for patients with non–small cell lung cancer (NSCLC). Janna Schoenmaekers, PhD, of the Maastricht University Medical Center, the Netherlands, and colleagues concluded that MRI, which detected 4.7% more brain metastases than CE-CT, is clinically relevant for patients with this type of lung cancer.

“Screening for [brain metastases] is mandatory in the workup of stage III NSCLC patients, and MRI is superior to a dedicated brain CE-CT,” the authors observed. “As the brain is a common site of relapse, prediction of [brain metastases] development and prevention of [brain metastases] should be the focus of clinical trials.”

In this observational, prospective, multicenter study, the investigators enrolled 149 patients who had been diagnosed with stage III NSCLC and had underwent CE-CT incorporated in the fluodeoxyglucose–positron-emission tomography as well as an additional MRI. After a multidisciplinary discussion, the authors determined that when comparing detection rates between the two strategies, a difference of more than 2% would qualify as clinically relevant.

Of the 149 patients enrolled, 7 (4.7%) were diagnosed with brain metastases via MRI without suspect lesions from CE-CT scans. The investigators found that 118 patients had a follow-up scan after at least 1 year (4 of which detected brain metastases after a baseline MRI). Of the remaining 114 patients, 8 (7%) developed symptomatic brain metastases 1 year after a negative staging brain MRI.

“Our results stress the importance of adequate screening for brain metastases in this patient population and that a brain MRI is necessary, even after a CE-CT of the brain,” the authors concluded.

Disclosure: The study authors’ disclosure information may be found at ejcancer.com.



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