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Parenchymal Metastases
Anne G. Osborn, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Parenchymal metastases (mets)
            • Synonyms

              • Secondary brain tumors
              • Body-to-brain metastases
              • Brain-to-brain metastases
            • Definitions

              • Secondary brain tumors (metastases) arise from
                • Tumors outside CNS that spread to CNS (usually via hematogenous dissemination)
                • Primary CNS neoplasms that spread from one site to another [usually geographic spread, e.g., along white matter (WM) tracts]

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          Selected References

                                          1. Kaufmann TJ et al: Consensus recommendations for a standardized brain tumor imaging protocol for clinical trials in brain metastases (BTIP-BM). Neuro Oncol. ePub, 2020
                                          2. Wanleenuwat P et al: Metastases to the central nervous system: molecular basis and clinical considerations. J Neurol Sci. 412:116755, 2020
                                          3. Doron H et al: A blazing landscape: neuroinflammation shapes brain metastasis. Cancer Res. 79(3):423-36, 2019
                                          4. Lee MD et al: Utility of percentage signal recovery and baseline signal in DSC-MRI optimized for relative CBV measurement for differentiating glioblastoma, lymphoma, metastasis, and meningioma. AJNR Am J Neuroradiol. 40(9):1445-50, 2019
                                          5. Rassy E et al: Advances in the management of brain metastases from cancer of unknown primary. Future Oncol. 15(23):2759-68, 2019
                                          6. You H et al: Immune Microenvironment of Brain Metastases-Are Microglia and Other Brain Macrophages Little Helpers? Front Immunol. 10:1941, 2019
                                          7. Neska-Matuszewska M et al: Differentiation of glioblastoma multiforme, metastases and primary central nervous system lymphomas using multiparametric perfusion and diffusion MR imaging of a tumor core and a peritumoral zone-Searching for a practical approach. PLoS One. 13(1):e0191341, 2018
                                          8. Kwak HS et al: Detection of small brain metastases at 3 T: comparing the diagnostic performances of contrast-enhanced T1-weighted SPACE, MPRAGE, and 2D FLASH imaging. Clin Imaging. ePub, 2015
                                          9. Pfannenberg C et al: [Whole-body staging of malignant melanoma: advantages, limitations and current importance of PET-CT, whole-body MRI and PET-MRI.] Radiologe. 55(2):120-6, 2015
                                          10. Puhalla S et al: Unsanctifying the sanctuary: challenges and opportunities with brain metastases. Neuro Oncol. 17(5):639-651, 2015
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Parenchymal metastases (mets)
                                                    • Synonyms

                                                      • Secondary brain tumors
                                                      • Body-to-brain metastases
                                                      • Brain-to-brain metastases
                                                    • Definitions

                                                      • Secondary brain tumors (metastases) arise from
                                                        • Tumors outside CNS that spread to CNS (usually via hematogenous dissemination)
                                                        • Primary CNS neoplasms that spread from one site to another [usually geographic spread, e.g., along white matter (WM) tracts]

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Angiographic Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  Selected References

                                                                                  1. Kaufmann TJ et al: Consensus recommendations for a standardized brain tumor imaging protocol for clinical trials in brain metastases (BTIP-BM). Neuro Oncol. ePub, 2020
                                                                                  2. Wanleenuwat P et al: Metastases to the central nervous system: molecular basis and clinical considerations. J Neurol Sci. 412:116755, 2020
                                                                                  3. Doron H et al: A blazing landscape: neuroinflammation shapes brain metastasis. Cancer Res. 79(3):423-36, 2019
                                                                                  4. Lee MD et al: Utility of percentage signal recovery and baseline signal in DSC-MRI optimized for relative CBV measurement for differentiating glioblastoma, lymphoma, metastasis, and meningioma. AJNR Am J Neuroradiol. 40(9):1445-50, 2019
                                                                                  5. Rassy E et al: Advances in the management of brain metastases from cancer of unknown primary. Future Oncol. 15(23):2759-68, 2019
                                                                                  6. You H et al: Immune Microenvironment of Brain Metastases-Are Microglia and Other Brain Macrophages Little Helpers? Front Immunol. 10:1941, 2019
                                                                                  7. Neska-Matuszewska M et al: Differentiation of glioblastoma multiforme, metastases and primary central nervous system lymphomas using multiparametric perfusion and diffusion MR imaging of a tumor core and a peritumoral zone-Searching for a practical approach. PLoS One. 13(1):e0191341, 2018
                                                                                  8. Kwak HS et al: Detection of small brain metastases at 3 T: comparing the diagnostic performances of contrast-enhanced T1-weighted SPACE, MPRAGE, and 2D FLASH imaging. Clin Imaging. ePub, 2015
                                                                                  9. Pfannenberg C et al: [Whole-body staging of malignant melanoma: advantages, limitations and current importance of PET-CT, whole-body MRI and PET-MRI.] Radiologe. 55(2):120-6, 2015
                                                                                  10. Puhalla S et al: Unsanctifying the sanctuary: challenges and opportunities with brain metastases. Neuro Oncol. 17(5):639-651, 2015