MRI sequencing of brain metastasis from lung malignancy: Literature review

Background: Lung cancer is ranked as the second most prevalent disease, with 2,2 million new cases anticipated by 2020. 85% of lung cancers are non-small-cell lung cancers (NSCLC), with 25-40% of NSCLC patients developing brain metastases during the course of the disease, typically within 2 years of the primary tumor's detection. Contrast-enhanced MRI is the preferred modality for judging cranial and intracranial metastases.

Methods: The most recent articles published between 2017 and 2023 were searched for in the databases of PubMed, Google Scholar, and Cochrane Library. Two reviewers (D and W, with more than 10 years of neurology and radiology experience, respectively) independently searched all papers.

Results: Cancer in the lung is most prevalent primary malignancy associated with CNS metastases, with 23% to 36% of lung cancer patients ultimately developing CNS metastases.6Patients with lung cancer and EGFR mutations in the brain metastases had a higher response rate to whole-brain radiation therapy and specific chemotherapy drugs.

For the detection of tiny metastases, MR is more sensitive than CT or even CT/PET. However, sensitivity on MR is variable, as various parameters of the MR capture can affect performance.5Therapeutically specialized brain metastases MRI procedures frequently include pre-contrast and post-contrast sequences.

Conclusion: MRI is the gold standard for evaluating patients with brain masses, such as primary and secondary due to metastatic malignancies. Brain metastases must be diagnosed early and distinguished from suspicion of other neuropathologies. Initial diagnosis influences prognosis and outcome.