[Impact of routine brain imaging in the initial management of lung cancer]

Rev Mal Respir. 2018 Jan;35(1):55-61. doi: 10.1016/j.rmr.2017.11.004. Epub 2018 Feb 4.
[Article in French]

Abstract

Introduction: Brain metastases are a common complication of bronchial carcinoma (BC). There is no consensus as to the need to undertake a systematic search for these lesions during the initial assessment. The aim of this study was to evaluate the contribution of brain imaging in the initial evaluation of patients with CB.

Methods: We undertook a retrospective analysis of patients treated in the Thoracic Oncology Clinic at the Institute Jules-Bordet between 01/09/2008 and 31/08/2013, who were treatment-naïve and were having a full diagnostic work-up including brain imaging.

Results: Four hundred and sixty-three patients consecutively diagnosed with BC were included. Brain magnetic resonance imaging and/or CT-scan showed brain metastases in 101 patients (21.8%), of whom 67 had no symptoms suggestive of brain metastatic disease. The addition of a brain imaging into the work-up procedure resulted in a stage migration for 30 patients (6.5%), mainly otherwise staged IIIA (n=10) or IIIB (n=14) without brain imaging.

Conclusion: The addition of brain imaging in the initial assessment of bronchial carcinoma allows the identification of brain metastases in one case among 5, of which 2/3 are asymptomatic. This leads to a change in staging, primarily for disease otherwise considered to be stage III.

Keywords: Cancer non à petites cellules; Cancer à petites cellules; Cancers bronchiques; Carcinoma; Lung neoplasms; Magnetic resonance imaging; Neoplasm staging; Non-small-cell-lung; Résonance magnétique cérébrale; Small-cell-lung; Stadification.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / secondary
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Diagnostic Tests, Routine / methods
  • Early Detection of Cancer / methods
  • Female
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / pathology
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Neoplasm Staging
  • Neuroimaging / methods*
  • Positron-Emission Tomography
  • Predictive Value of Tests
  • Retrospective Studies
  • Tomography, X-Ray Computed