American Journal of Neuroradiology, Vol 12, Issue 2 293-300, Copyright © 1991 by American Society of Neuroradiology
ARTICLES |
Diagnosis of cerebral metastases: double-dose delayed CT vs contrast- enhanced MR imaging
PC Davis, PA Hudgins, SB Peterman and JC Hoffman Jr
Department of Radiology, Emory University School of Medicine, Atlanta, GA 30322.
For patients suspected of having cerebral metastases, double-dose delayed CT (DDD-CT) has proved significantly more sensitive than CT scans obtained immediately after administration of a lesser dose of iodinated contrast material. Previous reports confirm the advantages of postcontrast MR imaging over contrast-enhanced CT, but data comparing DDD-CT and contrast-enhanced MR have not been reported. This study describes comparative imaging results in 23 patients who had contrast- enhanced MR imaging to clarify equivocal findings on DDD-CT studies. Contrast-enhanced MR demonstrated more than 67 definite or typical parenchymal metastases. T2-weighted MR revealed more than 40, while DDD- CT revealed only 37 typical metastatic lesions. Three patients had five or fewer lesions on DDD-CT and lesions "too numerous to count" on MR. The frequency of equivocal or unconvincing lesions was similar on DDD- CT (11) and contrast-enhanced MR (10). On T2-weighted images, we noted a substantially higher number of equivocal lesions (19), fewer definite metastases, and a number of definite metastases that had no corresponding lesion on the enhanced studies, confirming the inability of T2-weighted imaging to specifically identify cerebral metastases. In one case, multiple tiny lesions on T2-weighted images were not apparent on DDD-CT scans and were recognized only in retrospect on contrast- enhanced MR images. In this series, MR with enhancement proved superior to DDD-CT for lesion detection, anatomic localization of lesions, and differentiation of solitary vs multiple lesions. Cost-benefit considerations precluded a comparison between the two techniques in all patients suspected of having cerebral metastases.(ABSTRACT TRUNCATED AT 250 WORDS)
This article has been cited by other articles:
 |
|
 |
|
  M. A. Vogelbaum and J. H. Suh Resectable Brain Metastases J. Clin. Oncol., March 10, 2006; 24(8): 1289 - 1294. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. U. Lin, J. R. Bellon, and E. P. Winer CNS Metastases in Breast Cancer J. Clin. Oncol., September 1, 2004; 22(17): 3608 - 3617. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. D. Miller, T. Weathers, L. G. Haney, R. Timmerman, M. Dickler, J. Shen, and G. W. Sledge Jr Occult central nervous system involvement in patients with metastatic breast cancer: prevalence, predictive factors and impact on overall survival Ann. Onc., July 1, 2003; 14(7): 1072 - 1077. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Breslau, J. G. Jarvik, D. R. Haynor, W. T. Longstreth Jr, D. L. Kent, and K. R. Maravilla MR Contrast Media in Neuroimaging: A Critical Review of the Literature AJNR Am. J. Neuroradiol., April 1, 1999; 20(4): 670 - 675. [Abstract] [Full Text]
|
|
|
|
 |
|
 F. E. IV, J. H. Ryu, G. M. Miller, P. H. Luetmer, L. A. Forstrom, O. L. Burnett, C. M. Rowland, S. J. Swensen, and D. E. Midthun Suspected Non–Small Cell Lung Cancer: Incidence of Occult Brain and Skeletal Metastases and Effectiveness of Imaging for Detection—Pilot Study Radiology, April 1, 1999; 211(1): 137 - 145. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. A. Patchell, P. A. Tibbs, W. F. Regine, R. J. Dempsey, M. Mohiuddin, R. J. Kryscio, W. R. Markesbery, K. A. Foon, and B. Young Postoperative Radiotherapy in the Treatment of Single Metastases to the Brain: A Randomized Trial JAMA, November 4, 1998; 280(17): 1485 - 1489. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. P. Mintz and J. G. Cairncross Treatment of a Single Brain Metastasis: The Role of Radiation Following Surgical Resection JAMA, November 4, 1998; 280(17): 1527 - 1529. [Full Text] [PDF]
|
|
|
|
 |
|
 R. R Edelman and S. Warach Magnetic Resonance Imaging- First of Two Parts N. Engl. J. Med., March 11, 1993; 328(10): 708 - 716. [Full Text]
|
|