| Detection of Brain Metastatses Using Limited Brain MR Imaging ; Usefulness of Limited Contrast-Enhanced MR Imaging in Brain Metastasis. |
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Sun Jung Kwon, Yun Sun Lee, Jin Yong An, Hee Sun Park, Sung Soo Jung, Ju Ock Kim, Jin Hwan Kim, Chang Joon Song, Sun Young Kim |
1Division of Pulmonology, Department of Internal Medicine, Chungnam National University, Daejeon, Korea.
2Department of Diagnostic Radiology, College of Medicine, Chungnam National University, Daejon, Korea. sykim@cnu.ac.kr |
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| Abstract |
BACKGROUND
The brain is a common site of a metastasis in lung cancer patients. If left untreated, the patients succumb to progressive neurological deterioration with a lower survival rate than with other metastases sites. Contrast-enhanced MR imaging in the absence of symptoms or clinical signs is not recommended for identifying a cerebral metastasis in lung cancer patients because of management effectiveness. This pilot study was performed to estimate whether or not limited brain MR imaging, which has a lower cost, could be used to replace conventional brain MR imaging. METHOD: Between April 1999 and March 2001, 43 patients with a primary lung cancer and the others (breast cancer, stomach cancer, colon cancer, malignant melanoma etc), who had neurological symptoms and signs, were examined using conventional brain MR imaging to examine brain metastases. The control group involved four patients who had no evidence of brain metastases the sensitivity, specificity and correlation of limited brain MR imaging were compared with conventional brain MR imaging. RESULTS: All the 43 patients who were examined with conventional brain MR imaging showed evidence of brain metastases, whereas limited brain MR imaging indicated that 42 patients had brain metastases(sensitivity=97.67%). One patient in whom limited brain MR imaging showed no brain metastasis had a metastasis in the cerebellum, as shown by the contrast-enhanced T1 weighted axial view using conventional brain MR imaging. The conventional brain MR imaging and the limited brain MI imaging of the 4 control patients both indicated no brain metastases (specificity=100 %). The Pearson Correlation of the two groups was 0.884(Confidence Interval : 99%) observed. CONCLUSION: Limited brain MR imaging can detect a brain metastasis with the same accuracy. In addition, it is cost-effective (229,000 won, 180$) compared to conventional brain MR imaging(529,000 won, 480$) when patients had neurological symptoms and signs or staging. |
| Key Words:
Conventional brain MR imaging, Limited brain MR imaging, Brain metastases |
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