RESUMO
Background: Evolution of individualized radiosurgical therapeutic methods for brain metastasis as an ominous prognostic finding may encourage a more extensive application of neuroimaging in patients with extracerebral cancer. The aim of the present study was to investigate the added value of brain-included 18 F FDG PET/CT acquisition protocol based on primary cancer type and clinical indication
Materials and Methods: A retrospective review was performed on 3945 18 F FDG PET/CT reports of patients with extra-cerebral cancer underwent brain-included PET/CT study. Cerebral lesions suggestive of brain metastasis were subsequently verified by MRI, MRI+MRS, surgical pathology and a 1-year clinical formal follow up. The detection rate of new brain metastasis and related impact on disease status were then investigated in each cancer type based on clinical indication
Results: Of a total 3933 eligible patients, 44 [1.12%] were finally verified to have new cerebral metastasis. The most common primary sources were lung cancer [19/385, 4.93%], cancer of unknown primary [CUP] [5/168, 2.97%] and breast cancer [8/468, 1.71%]. The most common clinical indications were initial staging [17/44, 43.1%] and restaging [19/44, 36.4%]. Change in disease status occurred in 12 out of 44 patients [27.3%], more frequently occurred in lung cancer [n=4], in all indications and breast [n=3] cancers at restaging [n=7, 43.8%]
Conclusion: PET/CT acquisition protocol study may be best optimized based on the type of primary cancer and timing of evaluation. Brain-included field of view may be recommended for lung cancer regardless the clinical indication, cancer of unknown primary and breast cancer at restaging