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Computed tomography in intracranial, supratentorial metastases in children
H Pedersen1, J McConnell, D C Harwood-Nash
1Department of Radiology, Rigshospitalet, University of Copenhagen, Denmark.
Insights
This study compared CT scans of childhood supratentorial metastases and primary brain tumors. Metastases showed more bleeding and contrast enhancement, while primary tumors had more midline locations, calcifications, and cysts.
Area of Science:
- Pediatric Neuroradiology
- Neuro-oncology
- Medical Imaging
Background:
- Distinguishing supratentorial metastases from primary brain tumors in children is crucial for diagnosis and treatment planning.
- Cerebral metastases in pediatric patients are less common than primary brain tumors, necessitating clear imaging criteria for differentiation.
Purpose of the Study:
- To compare computed tomography (CT) characteristics of supratentorial metastases with primary tumors in the same location in children.
- To identify imaging features that differentiate metastatic lesions from primary central nervous system (CNS) tumors in pediatric patients.
Main Methods:
- Retrospective analysis of CT scans from 31 children with supratentorial metastases and 49 children with primary supratentorial tumors.
- Postcontrast CT imaging was utilized for the majority of cases.
- Comparison of imaging findings including location, enhancement patterns, calcification, cyst formation, and bleeding.
Main Results:
- Metastases were more frequently located at the gray-white matter junction compared to primary tumors.
- CT findings significantly less frequent in metastases included midline location, calcification, and cyst formation (P < 0.05).
- Findings significantly more frequent in metastases included bleeding and pronounced contrast enhancement (P < 0.05).
Conclusions:
- CT imaging reveals distinct characteristics that can help differentiate supratentorial metastases from primary tumors in children.
- The presence of bleeding and intense contrast enhancement on CT may suggest a metastatic origin in pediatric supratentorial lesions.
Abstract:
This study compares the CT characteristics in a consecutive sample of supratentorial metastases (n = 31) with primary tumors of the same location (n = 49) in childhood. Postcontrast CT was performed in all but one of the metastases cases. In all but one of these children the location and type of primary tumor was known at time of occurrence of cerebral metastasis. Primary CNS tumors (n = 12) had a higher incidense of supratentorial metastatic spread than tumor originating elsewhere. Three children had diffuse subarachnoid seeding, while 28 had solid tumors (21 solitary, 7 multiple). The predilection location for the solid metastases was the gray-white matter junction (n = 12). The following CT findings were significantly less frequent in metastases than in primary tumors (P less than 0.05): Midline location, calcification and cyst formation. On the other hand bleeding, pronounced contrast enhancement and location in the gray-white matter junction were more frequent in the metastatic group (P less than 0.05).