2025, Volume 18, Issue 6, pp 563 – 574

Magnetic resonance imaging characteristics of small cell and non-small cell lung cancer brain metastases: a retrospective study

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Authors and Affiliations

Corresponding author Emilia Adriana Marciuc, General and Dental Radiology, Faculty of Medicine, Grigore T Popa University of Medicine and Pharmacy, Iasi, Romania; Radiology Department, Emergency Hospital Prof Dr Nicolae Oblu, Iasi, Romania; E-mail: emma.marciuc@gmail.com

Abstract

Brain metastases (BMs) from bronchopulmonary tumors are a major cause of morbidity and mortality and significantly reduce the quality of life in oncology patients. Their treatment depends on imaging features (size, number, location) and their genetic mutation subtype, small-cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC). In patients with SCLC, prophylactic whole-brain radiotherapy (WBRT) with hippocampal sparing (HS) is recommended, whereas in patients with NSCLC, systemic targeted therapy is preferred. Multiple studies have analyzed the MRI morphology of BMs from both SCLC and NSCLC to identify specific imaging characteristics that can guide the selection of appropriate treatment. However, data on lung cancer (LC) brain metastases in patients from Romania are scarce or nonexistent. Our purpose was to investigate the imaging features of both NSCLC and SCLC BMs in our population using conventional MRI protocols. We selected patients from our hospital between 2019 and 2023 who had a histopathological diagnosis of LC BMs and underwent complete MRI exams prior to any radiotherapy or surgical treatment. For every MRI feature, we created both numerical and categorical variables, which were further studied using univariate, bivariate, and multivariate analyses, as well as a machine learning algorithm. We found 62 patients (49 men, 79.03% and 13 women, 20.96%) with confirmed LC BMs, of which 53 (85.49%) had NSCLC and 7 (11.29%) had SCLC. The sites affected were the cerebral hemisphere (56.46%), the cerebellum (40.32%), and the deep nuclei (6.45%), with the latter affecting relatively younger patients (P = 0.01), most notably in the case of thalamic situs (P = 0.0001). The SCLC subgroup showed a P value of 0.025 for the number of lesions, indicating diffuse spread. The AI algorithm identified positive and negative imaging diagnostic prediction variables, including internal vascularization and the number of lesions, respectively, as well as cystic lesions and internal hemorrhage. Further multicentric studies are needed to unravel the MRI features of LC BMs.

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About this article

PMC ID: 12314843
PubMed ID: 
DOI: 10.25122/jml-2024-0411

Article Publishing Date (print): 6 2025
Available Online: 

Journal information

ISSN Printing: 1844-122X
ISSN Online: 1844-3117
Journal Title: Journal of Medicine and Life

Copyright License: Open Access

This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use and redistribution provided that the original author and source are credited.


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