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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

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. 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
                                            2. 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
                                            3. Puhalla S et al: Unsanctifying the sanctuary: challenges and opportunities with brain metastases. Neuro Oncol. 17(5):639-651, 2015
                                            4. Rodriguez A et al: Neurosurgical management of brain metastases. Curr Probl Cancer. ePub, 2015
                                            5. Seidel C et al: Analysis of frequency of deep white matter metastasis on cerebral MRI. J Neurooncol. ePub, 2015
                                            6. Sneed PK et al: Adverse radiation effect after stereotactic radiosurgery for brain metastases: incidence, time course, and risk factors. J Neurosurg. 1-14, 2015
                                            7. Nensa F et al: Clinical applications of PET/MRI: current status and future perspectives. Diagn Interv Radiol. 20(5):438-47, 2014
                                            8. Chiang IC et al: Distinction between pyogenic brain abscess and necrotic brain tumour using 3-tesla MR spectroscopy, diffusion and perfusion imaging. Br J Radiol. Epub ahead of print, 2009
                                            9. Kato Y et al: Usefulness of contrast-enhanced T1-weighted sampling perfection with application-optimized contrasts by using different flip angle evolutions in detection of small brain metastasis at 3T MR imaging: comparison with magnetization-prepared rapid acquisition of gradient echo imaging. AJNR Am J Neuroradiol. 30(5):923-9, 2009
                                            10. Rizzo L et al: Role of diffusion- and perfusion-weighted MR imaging for brain tumour characterisation. Radiol Med. Epub ahead of print, 2009
                                            11. Wang S et al: Differentiation between glioblastomas and solitary brain metastases using diffusion tensor imaging. Neuroimage. 44(3):653-60, 2009
                                            12. Wang W et al: Diffusion tensor imaging in glioblastoma multiforme and brain metastases: the role of p, q, L, and fractional anisotropy. AJNR Am J Neuroradiol. 30(1):203-8, 2009
                                            13. Kitajima K et al: Accuracy of whole-body FDG-PET/CT for detecting brain metastases from non-central nervous system tumors. Ann Nucl Med. 22(7):595-602, 2008
                                            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

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. 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
                                                                                      2. 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
                                                                                      3. Puhalla S et al: Unsanctifying the sanctuary: challenges and opportunities with brain metastases. Neuro Oncol. 17(5):639-651, 2015
                                                                                      4. Rodriguez A et al: Neurosurgical management of brain metastases. Curr Probl Cancer. ePub, 2015
                                                                                      5. Seidel C et al: Analysis of frequency of deep white matter metastasis on cerebral MRI. J Neurooncol. ePub, 2015
                                                                                      6. Sneed PK et al: Adverse radiation effect after stereotactic radiosurgery for brain metastases: incidence, time course, and risk factors. J Neurosurg. 1-14, 2015
                                                                                      7. Nensa F et al: Clinical applications of PET/MRI: current status and future perspectives. Diagn Interv Radiol. 20(5):438-47, 2014
                                                                                      8. Chiang IC et al: Distinction between pyogenic brain abscess and necrotic brain tumour using 3-tesla MR spectroscopy, diffusion and perfusion imaging. Br J Radiol. Epub ahead of print, 2009
                                                                                      9. Kato Y et al: Usefulness of contrast-enhanced T1-weighted sampling perfection with application-optimized contrasts by using different flip angle evolutions in detection of small brain metastasis at 3T MR imaging: comparison with magnetization-prepared rapid acquisition of gradient echo imaging. AJNR Am J Neuroradiol. 30(5):923-9, 2009
                                                                                      10. Rizzo L et al: Role of diffusion- and perfusion-weighted MR imaging for brain tumour characterisation. Radiol Med. Epub ahead of print, 2009
                                                                                      11. Wang S et al: Differentiation between glioblastomas and solitary brain metastases using diffusion tensor imaging. Neuroimage. 44(3):653-60, 2009
                                                                                      12. Wang W et al: Diffusion tensor imaging in glioblastoma multiforme and brain metastases: the role of p, q, L, and fractional anisotropy. AJNR Am J Neuroradiol. 30(1):203-8, 2009
                                                                                      13. Kitajima K et al: Accuracy of whole-body FDG-PET/CT for detecting brain metastases from non-central nervous system tumors. Ann Nucl Med. 22(7):595-602, 2008