Cranial computed tomography of malignant melanoma

Area of Science:

• Neuroradiology
• Oncology
• Medical Imaging

Background:

• Malignant melanoma frequently metastasizes to the brain.
• Accurate detection of cerebral metastases is crucial for patient management and prognosis.

Purpose of the Study:

• To evaluate the efficacy of cranial computed tomography (CT) in detecting cerebral metastases from malignant melanoma.
• To characterize the CT findings associated with melanoma brain metastases.

Main Methods:

• Retrospective review of 275 cranial CT scans from 179 patients with malignant melanoma.
• Analysis of CT scan features, including precontrast attenuation and postcontrast enhancement.
• Correlation of CT findings with the presence and extent of bleeding within lesions.

Main Results:

• CT identified cerebral metastases in 93 of 101 patients with confirmed disease.
• Increased attenuation on precontrast scans was observed in 72% of metastases and enhanced postcontrast.
• Lesion density correlated with the extent of bleeding, with >20% red blood cells/HPF in hyperattenuating lesions.
• Occult metastases were found in 11% of patients without clinical brain involvement.

Conclusions:

• Cranial CT is a sensitive tool for diagnosing melanoma brain metastases.
• Characteristic CT findings include hyperattenuation and contrast enhancement, often associated with hemorrhage.
• Staging CT scans are recommended for patients with advanced or diffuse extracranial melanoma to detect asymptomatic cerebral metastases.