Imaging of brain metastases.

Area of Science:

• Neuroradiology
• Oncology
• Medical Imaging

Background:

• Central nervous system (CNS) metastasis diagnosis relies heavily on imaging.
• Standard modalities include computed tomography (CT) and magnetic resonance imaging (MRI).
• Challenges arise in differentiating solitary enhancing brain lesions without known malignancy.

Purpose of the Study:

• To review the imaging evaluation of suspected intracranial malignancy.
• To describe CT and MRI findings of parenchymal brain metastases.
• To explore advanced imaging for differential diagnosis.

Main Methods:

• Review of imaging modalities for CNS metastasis.
• Discussion of CT and MRI findings in brain metastases.
• Evaluation of advanced techniques: proton magnetic resonance spectroscopy (MRS), contrast-enhanced magnetic resonance perfusion (MRP), diffusion-weighted imaging (DWI), and diffusion tensor imaging (DTI).

Main Results:

• CT and MRI are primary tools for detecting brain metastases.
• Advanced imaging aids in diagnosing solitary enhancing lesions and differentiating metastases from high-grade gliomas.
• Hemorrhage presence offers clues to specific histological diagnoses.

Conclusions:

• Comprehensive imaging, including advanced techniques, is vital for accurate CNS metastasis diagnosis.
• Differentiating metastasis from other lesions like high-grade glioma is improved with advanced MRI.
• Extra-axial CNS involvement, such as leptomeningeal metastases, also requires specific imaging considerations.