Asymptomatic brain metastases (BM) in small cell lung cancer (SCLC): MR-imaging is useful at initial diagnosis.
OBJECTIVE
In this study we evaluated the usefulness of MR-imaging in the detection of asymptomatic brain metastases (BM) at the initial diagnosis in patients with small cell lung cancer (SCLC) and studied the follow-up of these patients.


METHODS
One-hundred and twenty-five patients with SCLC were investigated with MR-imaging.


RESULTS
In 112 patients with normal neurological findings, MR-imaging of the brain demonstrated BM in 17 patients (15%). Six of these 17 patients were therefore upgraded to extensive disease (ED). Two of these 17 patients died during chemotherapy because of progressive disease and 3 patients became neurologic symptomatic with progressive disease on MR-imaging of the brain. After completion of chemotherapy a repeated MR-imaging of the brain in the remaining 12 patients showed 1 complete remission, 4 partial remission and 7 progressive disease of the BM.


CONCLUSIONS
This study showed that at presentation an unexpectedly high percentage of SCLC patients had asymptomatic BM on MR-imaging. We propose that MR-imaging of the brain should be included in the staging of SCLC patients as well for staging, prognosis and therapy.
Hochstenbag
M M
MM
Department of Pulmonology, University Hospital Maastricht, The Netherlands. MHO@slon.azm.nl
Twijnstra
A
A
Wilmink
J T
JT
Wouters
E F
EF
ten Velde
G P
GP
D000971:Antineoplastic Combined Chemotherapy Protocols; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide