Abstract
BackgroundBrain metastases (BMs) are the most frequent malignancy of the central nervous system. Previous research suggested that some metastases show infiltrative behavior rather than sharp demarcation. We hypothesized that three magnetic resonance (MR) imaging parameters(a) tumor size, (b) extent of peritumoral edema, and (c) presence of multiple BMsare predictors of cellular invasion beyond ...
Abstract
BackgroundBrain metastases (BMs) are the most frequent malignancy of the central nervous system. Previous research suggested that some metastases show infiltrative behavior rather than sharp demarcation. We hypothesized that three magnetic resonance (MR) imaging parameters(a) tumor size, (b) extent of peritumoral edema, and (c) presence of multiple BMsare predictors of cellular invasion beyond the surgically identifiable tumor margins.MethodsWe performed a post hoc analysis on prospectively collected data of patients with BMs. Biopsies beyond the resection margin and immunohistochemistry were performed to assess infiltration status. The three MR imaging parameters were dichotomized into diameters 30mm (small) and >30mm (large), amount of peritumoral edema extended and limited, and multiple BMs and single BMs, respectively. The association between infiltration status and imaging parameters was calculated using chi-square test.ResultsBiopsy beyond the resection margin was performed in 77 patients; 49 (63.6%) had supramarginal infiltration and 28 patients (36.4%) showed no infiltration. Histological evidence of tumor infiltration was found in 25/41 patients with smaller lesions (61%) and in 24/36 with larger lesions (66.7%, p=0.64), in 28/44 patients with limited (63.6%) and in 21/33 patients with extended edema (63.6%, p=1.0), in 28/45 patients (62.2%) with single BM and in 21/32 patients (65.6%) with multiple BMs (p=0.81).ConclusionsBased on the post hoc analysis of our prospective trial data, we could not confirm the hypothesis that infiltration of brain parenchyma beyond the glial pseudocapsule is associated with the MR imaging parameters tumor size, extent of edema, or multiplicity of metastases.
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