Aims and objectives
The aim of this study was to identify the MRI sequences with highest diagnostic sensitivity for reliable early detection of melanoma brain metastasis (MBM). Approximately 40-50% of stage IV melanoma patients develop clinical manifestations of MBM,
while autopsy studies suggest an even higher prevalence of 55–75% –.
Since the introduction of new therapeutic possibilities in melanoma –,
early detection of metastases has an increasingly important role in managing patients with MBM...
Methods and materials
Patients and Ethics: This retrospective study was approved and patients´ consent was waived by the ethics committee of the University of Heidelberg.
Patients with brain metastasis from melanoma who were referred to our imaging center between November 2005 and December 2016 were included in the study and cranial MRIs (cMRI) at the time of first diagnosis of new MBM (hereinafter referred to as first diagnosis MRI) were analyzed. Imaging Protocol :
The majority of cMRI scans were performed at...
Patient data: Overall,
224 of 1210 (18.5%) melanoma patients had a record of metastatic brain lesions.
Seven of these had to be excluded due to unavailable cMRI.
Of the remaining 217 patients,
73 were female (33.6%) and 144 male (66.4%).
The patients’ mean age (SD) was 59.2 ± 13.1 years.
Forty-eight patients (22.1%) displayed a solitary MBM,
81 (37.3%) had 2 - 4 MBM and 88 patients (40.5%) showed 5 or more lesions.
720 MBM were evaluated.
Median lesion diameter (interquartile range...
Our results demonstrate the highest sensitivity of contrast-enhanced T1-weighted imaging for the detection of brain metastases from malignant melanoma beyond all other sequences.
While the usefulness of contrast-enhanced sequences for brain metastases was never questioned,
the clear superiority of ceT1w over all other sequences and its exquisite sensitivity was not expected to this degree and has implications for differential diagnosis of unclear suspicious findings in melanoma patients....
MD, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
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