Melanoma brain metastases: correlation of imaging features with genomic markers and patient survival.
Purpose To identify MR imaging features of melanoma brain metastases (MBM) that correlate with genetic profile of melanoma and patient survival. Materials and methods Patients with newly diagnosed melanoma metastases were identified from institutional database A retrospective review of brain MRI was performed focusing on lesion number, size, T1-, T2- and diffusion-weighted signal characteristics, hemorrhage, necrosis, enhancement pattern and edema. Genomic (BRAF status), treatment and survival data was collected. Results 98 patients were included in final analysis. A strong correlation was found between size of the largest lesion and the percent of lesions with T1-weighted hyperintense signal (R = 0.49), percent of lesions with size >1 cm (0.55), and the lesions that are clearly hemorrhagic (0.43). The analyzed imaging parameters were found to be independent of BRAF mutation status. The median survival of subjects with single lesion (9.1 months) was significantly higher than the median survival of subjects with more than 1 lesion (4.9 months) (p = 0.002). Patients with 2-18 lesions had significantly longer survival (5.6 months) than with >18 lesions (2 months) (p < 0.001). Other imaging parameters such as lesion size, T1-weighted hyperintensity, number of lesions with edema and hemorrhage were not found to be significantly related to survival. BRAF inhibitor treatment was found to be the most significant prognostic factor (p = 0.002) among patients with multiple lesions. Conclusion There is a statistically significant correlation between number of brain metastases and survival. In patients with multiple lesions, BRAF inhibitor treatment was the most significant prognostic factor.
Department of Radiology, Winthrop-University Hospital, 259 First St., Mineola, NY, 11501, USA. ritu.bordia@gmail.com.
Ritu
0000-0003-4141-1677
R
Bordia
Department of Population Health, NYU School of Medicine, New York, NY, USA.
Hua
H
Zhong
Department of Family Medicine, St. Josephs's Medical Center, Yonkers, NY, USA.
Joon
J
Lee
Department of Medical Oncology, Yale Cancer Center, New Haven, CT, USA.
Sarah
S
Weiss
School of Industrial Management Engineering, Korea University, Seoul, Republic of Korea.
Sung Won
SW
Han
Departments of Dermatology, Medicine and Urology, NYU School of Medicine, New York, NY, USA.
Iman
I
Osman
Department of Radiology, NYU School of Medicine, New York, NY, USA.
Rajan
R
Jain
D014408:Biomarkers, Tumor / Q000378:metabolism; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000401:mortality* / Q000556:secondary; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008545:Melanoma / Q000473:pathology*; D048493:Proto-Oncogene Proteins B-raf / Q000378:metabolism; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
BRAF; Brain metastases; Lesion number; Melanoma