Negative impact of leukoaraiosis on the incidence of brain metastases in patients with lung cancerReportar como inadecuado

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Journal of Neuro-Oncology

pp 1–8

First Online: 27 July 2017Received: 27 April 2017Accepted: 13 July 2017


The embolization of cancer cells to cerebral vessels occurs early in the multi-step metastatic process. We aimed to determine whether the presence of leukoaraiosis LA before treatment would predict the development of brain metastases BM in patients with lung cancer. Between January 2014 and June 2015, 1007 patients underwent initial i.e., prior to any chemotherapy or routine magnetic resonance MR imaging of the brain and exhibited no evidence of BM. Of these, 189 underwent repeat MR imaging; 34 of 189 patients 18% developed new BM, whereas 155 patients did not. LA was retrospectively evaluated according to Fazekas scale on the initial screening MR images of these 189 patients. The frequency of grade 0 periventricular hyperintensity PVH was greater among patients with BM, compared to those without BM p = 0.001. In a multivariate analysis, patients with adenocarcinoma 95% confidence interval CI 1.8–171.8 and small cell carcinoma 95% CI 1.4–172.4 respectively developed BM at 9.3- and 8.8-fold higher rates than those with squamous cell carcinoma. Patients with grade 0 PVH developed BM at a rate 3.5-, 8.6-, and 3.6-fold higher rates than those with grade 1 95% CI 1.4–9.0, 2 95% CI 2.4–41.9, and 3 95% CI 1.02–15.0, respectively. Lung cancer patients with grade 0 PVH on initial MR images have a high subsequent incidence of BM. PVH is a useful method for evaluating risk of BM.

KeywordsBrain metastasis Leukoaraiosis Lung cancer Magnetic resonance imaging White matter lesion  Download fulltext PDF

Autor: Nakamasa Hayashi - Koichi Mitsuya - Yoko Nakasu - Tateaki Naito - Fumiharu Ohka - Toshiaki Takahashi


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