title: Yield of Preoperative Whole-body CT in Patients Presenting with Single Brain Malignancy:: Experience at a Tertiary-care Center.
abstract: OBJECTIVE
  Single brain malignancy (SBM) often poses a diagnostic dilemma, with differential diagnosis of primary brain malignancy (PBM) versus metastasis commonly rendered. This study assesses the yield of preoperative computed tomography (CT) of the chest, abdomen, and pelvis (CTCAP) in patients with SBM.
  
  
  METHODS
  Institutional review board (IRB)-approved retrospective review of the imaging database at a tertiary-care center was performed for patients with magnetic resonance findings compatible with a diagnosis of SBM. Demographic information, lesion characteristics (location and size), and pathology were recorded. Findings of CTCAP for metastatic workup prior to SBM excisional biopsy were also documented, if performed.
  
  
  RESULTS
  Eighty-six of 92 patients with new diagnosis of SBM on MR imaging had subsequent lesion resection and pathology consistent with malignancy. PBM accounted for 51 cases (59%) and metastasis accounted for 35 cases (41%). When stratified by age group, PBM was more common in patients <50 years old (15 of 18 (83%)), whereas similar rates of PBM and metastatic disease were identified in older patients. When stratified by lesion size, PBM was more common in tumors ≥40 mm (25 of 31 (81%)), whereas similar rates of PBM and metastatic disease were identified in smaller lesions. Lung cancer was the most common CTCAP and pathology-confirmed source of metastatic SBM (68% and 66%, respectively).
  
  
  CONCLUSIONS
  The yield of preoperative CTCAP can be increased by targeting patients older than 50 years of age with SBMs smaller than 40 mm in size.
authors.affiliation: Thomas Jefferson University Hospitals, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107.
authors.forename: Huan
authors.initials: H
authors.lastname: Dong
authors.affiliation: Thomas Jefferson University Hospitals, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107. Electronic address: mougnyan.cox@gmail.com.
authors.forename: Mougnyan
authors.initials: M
authors.lastname: Cox
authors.affiliation: Thomas Jefferson University Hospitals, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107.
authors.forename: Santosh
authors.initials: S
authors.lastname: Selvarajan
authors.affiliation: Thomas Jefferson University Hospitals, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107.
authors.forename: Christopher
authors.initials: C
authors.lastname: Roth
authors.affiliation: Thomas Jefferson University Hospitals, 132 South 10th Street, 1087 Main Building, Philadelphia, PA 19107.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Deshmukh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000706:statistics & numerical data; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D005909:Glioblastoma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging; D011860:Radiography, Abdominal / Q000706:statistics & numerical data; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D051598:Whole Body Imaging / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: CT; Single or solitary brain malignancy; abdomen; chest; metastasis; screening