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Huang Z, Tu X, Yu T, Zhan Z, Lin Q, Huang X. Peritumoural MRI radiomics signature of brain metastases can predict epidermal growth factor receptor mutation status in lung adenocarcinoma. Clin Radiol 2024; 79:e305-e316. [PMID: 38000953 DOI: 10.1016/j.crad.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023]
Abstract
AIM To investigate whether magnetic resonance imaging (MRI) radiomics features of brain metastases (BMs) can predict epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma. MATERIALS AND METHODS Between June 2014 and December 2022, 58 histopathologically confirmed lung adenocarcinoma patients (27 with EGFR wild-type, 31 with EGFR mutation) who underwent gadobenate dimeglumine-enhanced brain MRI were recruited retrospectively. A total of 123 metastatic brain lesions were allocated randomly into the training cohort (n=86) and test cohort (n=37) at a ratio of 7:3. Radiomics models based on multi-sequence MRI images in different regions such as volume of interest (VOI)enhancing tumour, VOIwholetumour, VOIperitumour 1mm, VOIperitumour 3mm, and VOIperitumour 5mm were built. The optimal radiomics model was integrated into the clinical or radiological indicators to construct a fusion model through multivariable logistic regression analysis. RESULTS The optimal radiomics model based on the VOIperitumour 1mm, a combination of nine features selected from the fluid-attenuated inversion recovery (FLAIR) sequence, yielded areas under the curves (AUCs) of >0.75 in the training and test cohorts. The prediction of the fusion model with integration of clinical factors (age) and radiomics score (the optimal radiomics model) was not better than that of the optimal radiomics model alone in the test cohort (AUC: 0.808 and 0.785, respectively, p=0.525). CONCLUSION The FLAIR radiomics model based on VOIperitumour 1mm as an effective biomarker helps predict EGFR mutation status in lung adenocarcinoma patients with BMs and then assists clinicians in selecting optimal treatment strategies.
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Affiliation(s)
- Z Huang
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China.
| | - X Tu
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| | - T Yu
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| | - Z Zhan
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| | - Q Lin
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
| | - X Huang
- Department of Radiology, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 North 91 Road, Xinluo District, Fujian, 364000, China
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Zheng Y, Huang WJ, Han N, Jiang YL, Ma LY, Zhang J. MRI features and whole-lesion apparent diffusion coefficient histogram analysis of brain metastasis from non-small cell lung cancer for differentiating epidermal growth factor receptor mutation status. Clin Radiol 2023; 78:e243-e250. [PMID: 36577557 DOI: 10.1016/j.crad.2022.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/08/2022] [Accepted: 11/18/2022] [Indexed: 12/27/2022]
Abstract
AIM To explore the utility of magnetic resonance imaging (MRI) characteristics and whole-lesion apparent diffusion coefficient histogram analysis of brain metastasis from non-small cell lung cancer (NSCLC) in the differentiation of epidermal growth factor receptor (EGFR) mutation status. MATERIALS AND METHODS Forty-eight patients with brain metastases from NSCLC were enrolled in this retrospective study. Patients were subtyped into EGFR mutation (23 cases) and wild-type (25 cases) groups. Whole-lesion histogram metrics were derived from the apparent diffusion coefficient (ADC) maps, and imaging features were evaluated according to conventional MRI. Student's t-test or Mann-Whitney U-test, chi-squared test, and receiver operating characteristic (ROC) curve analysis were performed to discriminate the two groups and to determine the diagnostic efficacy of ADC histogram parameters. RESULTS EGFR mutation group had more multiple brain metastases, less peritumoural brain oedema (PTBO), and lower peritumoural brain oedema index (PTBO-I) than EGFR wild-type group (all p<0.05). In addition, 90th and 75th percentiles of ADC and maximum ADC in the EGFR mutation group were significantly higher than in the EGFR wild-type group (all p<0.05). Ninetieth percentile of ADC had the highest area under the curve (AUC; 0.711), and it was found to outperform 75th percentile of ADC (AUC, 0.662; p=0.039) and maximum ADC (AUC, 0.681). CONCLUSIONS Whole-lesion ADC histogram analysis and MRI features of brain metastasis from NSCLC are expected to be potential biomarkers to non-invasively differentiate the EGFR mutation status.
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Affiliation(s)
- Y Zheng
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - W-J Huang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - N Han
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Y-L Jiang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - L-Y Ma
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - J Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China; Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China.
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Wang Y, Xia W, Liu B, Zhou L, Ni M, Zhang R, Shen J, Bai Y, Weng G, Yuan S, Gao X. Exploration of spatial distribution of brain metastasis from small cell lung cancer and identification of metastatic risk level of brain regions: a multicenter, retrospective study. Cancer Imaging 2021; 21:41. [PMID: 34120659 PMCID: PMC8201893 DOI: 10.1186/s40644-021-00410-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aimed to explore the spatial distribution of brain metastases (BMs) from small cell lung cancer (SCLC) a homogenous sample, and to identify the metastatic risk levels in brain regions. Methods T1-enhanced magnetic resonance imaging (MRI) from SCLC patients were retrospectively reviewed from three medical institutions in China. All images were registered to the standard brain template provided by the Montreal Neurological Institute (MNI) 152 database, followed by transformation of the location of all BMs to the space of standard brain. The MNI structural atlas and Anatomical Automatic Labeling (AAL) atlas were then used to identify the anatomical brain regions, and the observed and expected rates of BMs were compared using 2-tailed proportional hypothesis testing. The locations and sizes of brain lesions were analyzed after image standardization. Results A total of 215 eligible patients with 1033 lesions were screened by MRI, including 157 (73%) males and 58 (27%) females. The incidence of crucial structures were as follows: hippocampus 0.68%, parahippocampal 0.97%, brainstem 2.05%, cauate 0.68%, putamen 0.68%, pallidum 0.2%, thalamus 1.36%. No BMs were found in the amygdala, pituitary gland, or pineal gland. The cumulative frequency of the important structures was 6.62%. Based on the results of MNI structural atlas, the cerebellum, deep white matter and brainstem was identified as a higher risk region than expected for BMs (P = 9.80 ×10−15, 9.04 ×10−6), whereas temporal lobe were low-risk regions (P = 1.65 ×10−4). More detailed AAL atlas revealed that the low-risk regions for BMs was inferior frontal gyrus (P = 6.971 ×10−4), while the high-risk regions for BMs was cerebellar hemispheres (P = 1.177 ×10−9). Conclusion Many crucial structures including the hippocampus, parahippocampus, pituitary gland and thalamus etc. have low frequency of brain metastases in a population of SCLC patients. This study provides the help to investigate the clinical feasibility of HA-WBRT and non-uniform dose of PCI in a population of SCLC patients. Supplementary Information The online version contains supplementary material available at 10.1186/s40644-021-00410-w.
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Affiliation(s)
- Yong Wang
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440, Jiyan Road, Jinan, 250117, Shandong, China
| | - Wei Xia
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, 88 Keling Road, Suzhou New District, Suzhou, 215163, Jiangsu, China.,Jinan Guoke Medical Engineering and Technology Development Co., Ltd., Pharmaceutical Valley New Drug Creation Platform, Jinan, Shandong, China
| | - Baoyan Liu
- Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Liu Zhou
- Jihua Laboratory, Foshan, Guangdong, China
| | - Meng Ni
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440, Jiyan Road, Jinan, 250117, Shandong, China
| | - Rui Zhang
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, 88 Keling Road, Suzhou New District, Suzhou, 215163, Jiangsu, China
| | - Jingyi Shen
- Fudan University Shanghai Cancer Center; Shanghai Medical College, Fudan University, shanghai, China
| | - Yujun Bai
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440, Jiyan Road, Jinan, 250117, Shandong, China
| | | | - Shuanghu Yuan
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China. .,Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No.440, Jiyan Road, Jinan, 250117, Shandong, China.
| | - Xin Gao
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, 88 Keling Road, Suzhou New District, Suzhou, 215163, Jiangsu, China. .,Jinan Guoke Medical Engineering and Technology Development Co., Ltd., Pharmaceutical Valley New Drug Creation Platform, Jinan, Shandong, China.
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Fu Y, Tang Y, Zheng Y, Chen YY, Hong Y, Wang PP, Li Q, Liu T, Ding ZY. Imaging Pattern of Diffuse Intrapulmonary Metastases in Lung Cancer Was Associated with Poor Prognosis to Epidermal Growth Factor Receptor Inhibitors. Cancer Manag Res 2020; 12:11761-11772. [PMID: 33235504 PMCID: PMC7680171 DOI: 10.2147/cmar.s261983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/24/2020] [Indexed: 02/05/2023] Open
Abstract
Background Epidermal growth factor receptor (EGFR) mutations are more frequently seen in miliary intrapulmonary metastases than EGFR wild-type non-small cell lung cancer (NSCLC). Also, small-scale retrospective studies showed that patients harboring EGFR mutation with miliary pulmonary metastases had a worse prognosis. This study aimed to explore the impact of imaging patterns on the outcomes of EGFR tyrosine kinase inhibitor (TKI) treatment. Methods A cohort of treatment-naive NSCLC patients harboring EGFR mutation with intrapulmonary metastases who were prescribed with TKI were enrolled. The demographic feature, clinical outcome, and CT imaging of each patient were reviewed and analyzed. Results A cohort of 174 patients were enrolled. Five intrapulmonary patterns of imaging were recognized: solid nodular, ground-glass nodular, miliary, multiple uniform nodular, and not otherwise specified. Among them, miliary and multiple uniform nodular patterns had similar poor prognosis, and, therefore, were combined as diffuse group. A worse PFS (9.0 mon, 95% CI: 8.0–10.0 mon) was observed compared with the rest (non-diffuse group, 13.3 mon, 95% CI: 10.2–16.4 mon, p<0.001, HR=0.49). The objective response rates (ORR) between the two groups were 76.8% and 84.1%, respectively, with no significant difference (p = 0.474). The OS of the diffuse and the non-diffuse group were 25.6 mon (95% CI 21.9–29.3 mon) and 35.0 mon (95% CI: 27.5–42.5, p = 0.01, HR= 0.59). Organs like bone (p=0.167), liver (p=0.513), and adrenal gland (p=0.375) were involved in similar frequencies in both groups. However, brain (p=0.070) and leptomeningeal (p=0.078) metastases were less common in the non-diffuse group with marginally statistical significance. The 2 groups contained similar missense mutations, and gene amplification was more common in the non-diffuse group. Conclusion Patients with diffuse intrapulmonary metastases had inferior outcomes after TKI treatment. More aggressive treatments might be warranted for these patients.
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Affiliation(s)
- Yang Fu
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, People's Republic of China
| | - Yuan Tang
- Department of Pathology, West China Hospital, West China Medical School, Sichuan University, Chengdu, People's Republic of China
| | - Yue Zheng
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, People's Republic of China
| | - Yue-Yun Chen
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, People's Republic of China
| | - Ye Hong
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, People's Republic of China
| | - Pei-Pei Wang
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, People's Republic of China
| | - Qing Li
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, People's Republic of China
| | - Ting Liu
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, People's Republic of China
| | - Zhen-Yu Ding
- Department of Biotherapy, Cancer Center, West China Hospital, West China Medical School, State Key Laboratory of Biotherapy, Sichuan University, Chengdu, People's Republic of China
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Miliary breast cancer brain metastasis: a rare and aggressive form of central nervous system metastasis. Br J Cancer 2020; 123:1349-1350. [PMID: 32747746 PMCID: PMC7591525 DOI: 10.1038/s41416-020-1001-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 11/29/2022] Open
Abstract
Although breast cancer brain metastasis is an increasingly common occurrence, relatively little is known about miliary brain metastases, a rare subtype that presents unique diagnostic and management challenges. The present study from Bashour et al. proposes the first objective diagnostic imaging criteria, enabling improved future study.
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Vienne A, Dulou R, Bielle F, Baruteau M, Maison FL, Nikolova Yordanova Y. Awake surgery for isolated parenchymal degenerating neurocysticercosis - Case report and focused review of misdiagnosis of neurocysticercosis. Neurochirurgie 2019; 65:402-416. [PMID: 31518578 DOI: 10.1016/j.neuchi.2019.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/05/2019] [Accepted: 07/28/2019] [Indexed: 11/30/2022]
Abstract
Differential diagnosis of isolated single neurocysticercosis can be difficult, and management is controversial. We report here an original surgical strategy, and review previous studies reporting misdiagnosis, using the PRISMA guidelines. A 24-year-old man was admitted to our hospital for recent memory impairment, hypoesthesia of the right hand, and recurrent focal seizures without loss of consciousness. Brain MRI revealed a single ring-enhancing parenchymal lesion in the left superior postcentral gyrus, with large perilesional edema. Since exhaustive systemic exploration was negative, surgical resection of the lesion was decided on in a multidisciplinary team meeting. To preserve eloquent brain areas, surgery was performed in awake condition. It allowed complete resolution of clinical manifestations. The diagnosis of neurocysticercosis was confirmed on pathology. This case illustrates the utility of awake surgery in degenerating neurocysticercosis in functional areas, and emphasizes the importance of including it in differential diagnosis of cystic ring-enhancing brain lesions.
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Affiliation(s)
- A Vienne
- Defense Health Service, Cognition and Action Group, Cognac-G, CNRS UMR 8257, Paris Descartes University, 45, rue des Saints-Pères, 75006 Paris, France; Department of Neurosurgery, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - R Dulou
- Department of Neurosurgery, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France; Val de Grâce Military Medical Corps Academy, 74, boulevard du Port-Royal, 75005 Paris, France
| | - F Bielle
- Department of Neuropathology, Pitié-Salpêtrière Hospital, 41-83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Baruteau
- Department of Neurology, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - F-L Maison
- Department of Neurosurgery, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France
| | - Y Nikolova Yordanova
- Department of Neurosurgery, 'Percy' Military Hospital, 101, avenue Henri-Barbusse, 92140 Clamart, France.
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Reiter FP, Giessen-Jung C, Dorostkar MM, Ertl-Wagner B, Denk GU, Heck S, Rieger CT, Pfister HW, op den Winkel M. Miliary pattern of brain metastases - a case report of a hyperacute onset in a patient with malignant melanoma documented by magnetic resonance imaging. Radiat Oncol 2015; 10:148. [PMID: 26187589 PMCID: PMC4506569 DOI: 10.1186/s13014-015-0459-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/07/2015] [Indexed: 11/17/2022] Open
Abstract
Background Miliary brain metastases are a rare condition but associated with an exceedingly poor prognosis. We present the case of a patient suffering from malignant melanoma with an acute progressively worsening of neurological symptoms up to the loss of consciousness. The magnetic resonance imaging (MRI) demonstrated a new onset of disseminated, miliary spread of central nervous system metastases from a malignant melanoma within 4 days. Case presentation We report on a 57-year-old woman suffering from metastatic malignant melanoma positive for BRAF-V600E mutation who developed an acute onset of neurological symptoms. The patient received vemurafenib and dacarbacin as chemotherapeutic regime for treatment of malignant melanoma. After admission to our hospital due to progressive disturbance of memory and speech difficulty a magnetic resonance tomography (MRI) was performed. This showed no evidence of cerebral tumour manifestation. The symptoms progressed until a loss of consciousness occurred on day five after admission and the patient was admitted to our intensive care unit for orotracheal intubation. No evidence for infectious, metabolic or autoimmune cerebral disorders was found. Due to the inexplicable acute worsening of the neurological symptoms a second MRI was performed on day five. This revealed a new onset of innumerable contrast-enhancing miliary lesions, especially in the grey matter which was proven as metastases from malignant melanoma on histopathology. Conclusion This case describes an unique hyperacute onset of tumour progression correlating with an acute deterioration of neurological symptoms in a patient suffering from miliary brain metastasis from BRAF positive malignant melanoma.
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Affiliation(s)
- Florian P Reiter
- Department of Internal Medicine II, Liver Center Munich, University of Munich, Grosshadern Campus, Marchioninistr. 15, D-81377, Munich, Germany.
| | - Clemens Giessen-Jung
- Department of Internal Medicine III, Hematology and Medical Oncology, University of Munich, Grosshadern Campus, Marchioninistr. 15, D-81377, Munich, Germany.
| | - Mario M Dorostkar
- Center for Neuropathology and Prion Research, University of Munich, Feodor-Lynen-Str. 23, D-81377, Munich, Germany.
| | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, University of Munich, Grosshadern Campus, Marchioninistr. 15, D-81377, Munich, Germany.
| | - Gerald U Denk
- Department of Internal Medicine II, Liver Center Munich, University of Munich, Grosshadern Campus, Marchioninistr. 15, D-81377, Munich, Germany.
| | - Suzette Heck
- Department of Neurology, University of Munich, Grosshadern Campus, Marchioninistr. 15, D-81377, Munich, Germany.
| | - Christina T Rieger
- Department of Internal Medicine III, Hematology and Medical Oncology, University of Munich, Grosshadern Campus, Marchioninistr. 15, D-81377, Munich, Germany.
| | - Hans W Pfister
- Department of Neurology, University of Munich, Grosshadern Campus, Marchioninistr. 15, D-81377, Munich, Germany.
| | - Mark op den Winkel
- Department of Internal Medicine II, Liver Center Munich, University of Munich, Grosshadern Campus, Marchioninistr. 15, D-81377, Munich, Germany.
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Liu Y, Chen J. [Advances in diagnosis and treatment of brain metastases from the primary lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2013; 16:382-6. [PMID: 23866671 PMCID: PMC6000654 DOI: 10.3779/j.issn.1009-3419.2013.07.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
肺癌脑转移的发生率为23%-65%,是脑转移性肿瘤中最常见的类型,且预后较差。目前肺癌脑转移的诊治和分子机理已成为众多研究的热点之一。本文就肺癌脑转移的临床特征、诊断和治疗方面的进展以及最新脑转移的机制学研究做了系统的综述。
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Affiliation(s)
- Yi Liu
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
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Falk AT, Poudenx M, Otto J, Ghalloussi H, Barrire J. Adenocarcinoma of the lung with miliary brain and pulmonary metastases with echinoderm microtubule-associated protein like 4-anaplastic lymphoma kinase translocation treated with crizotinib: A case report. Lung Cancer 2012; 78:282-4. [DOI: 10.1016/j.lungcan.2012.08.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 08/09/2012] [Accepted: 08/26/2012] [Indexed: 11/25/2022]
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Singh JB, Oevermann A, Henke D, Segard E, Gorgas D. IMAGING DIAGNOSIS-LACK OF CONTRAST ENHANCEMENT IN METASTATIC CEREBRAL ADENOCARCINOMA. Vet Radiol Ultrasound 2012; 53:193-6. [DOI: 10.1111/j.1740-8261.2011.01890.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Current World Literature. Curr Opin Support Palliat Care 2012; 6:109-25. [DOI: 10.1097/spc.0b013e328350f70c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sekine A, Kato T, Hagiwara E, Shinohara T, Komagata T, Iwasawa T, Satoh H, Tamura K, Kasamatsu T, Hayashihara K, Saito T, Takahashi H, Ogura T. Metastatic brain tumors from non-small cell lung cancer with EGFR mutations: distinguishing influence of exon 19 deletion on radiographic features. Lung Cancer 2012; 77:64-9. [PMID: 22335887 DOI: 10.1016/j.lungcan.2011.12.017] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 12/21/2011] [Accepted: 12/26/2011] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Miliary brain metastasis is a rarity and refers to the presence of numerous small tumors in a perivascular distribution without intraparenchymal invasion and focal edema. Although the presence of epidermal growth factor receptor (EGFR) mutation and good response to gefitinib have been reported in non-small cell lung cancer (NSCLC) patients with miliary brain metastases, the influence of the EGFR mutations on the radiographic features remains unclear. PATIENTS AND METHODS All NSCLC patients with synchronous brain metastases detected at the time of a new diagnosis of NSCLC from March 2005 through May 2011 were divided according to EGFR mutation status. The number of brain tumors, size of the largest brain tumors, and size of peritumoral brain edema were compared among the groups. RESULTS Fifty-seven patients who met the criteria were divided into three groups: wild-type EGFR group (31 patients), exon 19 deletion group (18 patients), and exon 21 point mutation group (8 patients). The exon 19 deletion group had more multiple and smaller brain tumors with smaller peritumoral brain edema than did the wild-type group (P = 0.024, P = 0.0016, and P = 0.0036, respectively). The exon 21 point mutation group showed no significant difference in any of the radiographic values when compared with the wild-type group. CONCLUSION Our results indicate that NSCLC patients with the exon 19 deletion have such a peculiar pattern of brain metastases as multiple small metastases with small brain edema. This metastatic pattern may be similar to that of miliary brain metastases. Because it is unclear whether or not severe neurologic symptoms develop during their clinical courses like miliary brain metastases, regular evaluation with brain magnetic resonance imaging (MRI) should be considered, regardless of the presence of neurologic symptoms. Accumulation of knowledge about specific pattern of brain metastasis will help approach to "individual" management.
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Affiliation(s)
- Akimasa Sekine
- Department of Respiratory Medicine, Kanagawa Prefectural Cardiovascular and Respiratory Center, Yokohama, Japan.
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Lee HJ, Oh IJ, Park SW, Ban HJ, Kim YC, Kim SO. A Case of Miliary Brain Metastasis of Lung Cancer Mimicking Neurocysticercosis. Tuberc Respir Dis (Seoul) 2012. [DOI: 10.4046/trd.2012.72.2.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Ho-Jun Lee
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Sang-Woo Park
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Hee-Jung Ban
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Soo-Ok Kim
- Department of Internal Medicine, Seonam University College of Medicine, Gwangju, Korea
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