title: [Brain metastases imaging].
abstract: The therapeutic management of brain metastases depends upon their diagnosis and characteristics. It is therefore imperative that imaging provides accurate diagnosis, identification, size and localization information of intracranial lesions in patients with presumed cerebral metastatic disease. MRI exhibits superior sensitivity to CT for small lesions identification and to evaluate their precise anatomical location. The CT-scan will be made only in case of MRI's contraindication or if MRI cannot be obtained in an acceptable delay for the management of the patient. In clinical practice, the radiologic metastasis evaluation is based on visual image analyses. Thus, a particular attention is paid to the imaging protocol with the aim to optimize the diagnosis of small lesions and to evaluate their evolution. The MRI protocol must include: 1) non-contrast T1, 2) diffusion, 3) T2* or susceptibility-weighted imaging, 4) dynamic susceptibility contrast perfusion, 5) FLAIR with contrast injection, 6) T1 with contrast injection preferentially using the 3D spin echo images. The role of the nuclear medicine imaging is still limited in the diagnosis of brain metastasis. The Tc-sestamibi brain imaging or PET with amino acid tracers can differentiate local brain metastasis recurrence from radionecrosis but still to be evaluated.
authors: Service de neuroradiologie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France.
authors: C
authors: C
authors: Delmaire
authors: Service de neuroradiologie, fondation Rothschild, 78, rue de Picpus, 75012 Paris, France.
authors: J
authors: J
authors: Savatovsky
authors: Service de radiologie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France.
authors: T
authors: T
authors: Boulanger
authors: Service de radiothérapie, institut de cancérologie Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
authors: F
authors: F
authors: Dhermain
authors: Neuro-oncologie, département de neurochirurgie, hôpital Roger-Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France; Oncologie médicale, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France; Laboratoire Prism, université Lille 1, bâtiment SN3 1(er) étage, 59655 Villeneuve-d'Ascq cedex, France; Inserm U1192, 59655 Villeneuve-d'Ascq cedex, France; Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France.
authors: E
authors: E
authors: Le Rhun
authors: Groupe de réflexion sur la prise en charge des métastases cérébrales (GRPCMaC), 13273 Marseille cedex 09, France; Département de neurochirurgie, CHU La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Centre de recherche en oncologie et oncopharmacologie (CRO2), faculté de médecine Timone, université Aix-Marseille, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France; Inserm U911, faculté de médecine Timone, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France. Electronic address: philippe.metellus@mail.ap-hm.fr.
authors: P
authors: P
authors: Météllus
authors: Service de neuroradiologie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
authors: S
authors: S
authors: Gerber
authors: Service de neuroradiologie, CHU de Rennes, 2, rue Henri-Le Guilloux, 35033 Rennes cedex 9, France.
authors: B
authors: B
authors: Carsin-Nicole
authors: Service de médecine nucléaire, centre Oscar-Lambret, CHRU de Lille, 3, rue Frédéric-Combemale, BP 307, 59020 Lille cedex, France.
authors: G
authors: G
authors: Petyt
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary*; D002250:Carbon Radioisotopes; D002277:Carcinoma / Q000453:epidemiology / Q000556:secondary; D002985:Clinical Protocols; D003287:Contrast Media / Q000009:adverse effects; D003952:Diagnostic Imaging / Q000379:methods*; D005682:Gadolinium / Q000009:adverse effects; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000453:epidemiology / Q000556:secondary; D008715:Methionine; D059906:Neuroimaging / Q000379:methods*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D014057:Tomography, X-Ray Computed
chemical_list: D002250:Carbon Radioisotopes; D003287:Contrast Media; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D008715:Methionine; D005682:Gadolinium
keywords: Brain metastasis; IRM; MIBI; MRI; Médecine nucléaire; Métastases cérébrales; Nuclear medicine; PET; TEP