Hayashi N, et al. – The authors conducted this study to determine whether the presence of leukoaraiosis (LA) before treatment would predict the development of brain metastases (BM) in patients with lung cancer. The results seemed to suggest that lung cancer patients with grade 0 periventricular hyperintensity (PVH) on initial magnetic resonance (MR) images have a high subsequent incidence of BM. They recommended that PVH is a valuable method for evaluating the risk of BM.

Methods

• For this study, 1007 patients underwent initial (i.e., prior to any chemotherapy) or routine magnetic resonance (MR) imaging of the brain and exhibited no evidence of BM between January 2014 and June 2015.
• Of these, one hundred eighty-nine underwent repeat MR imaging; 34 of 189 patients (18%) developed new BM, whereas one hundred fifty-five patients did not.
• LA was retrospectively assessed according to Fazekas scale on the initial screening MR images of these one hundred eighty-nine patients.

Results

• The results of this study showed that the frequency of grade 0 periventricular hyperintensity (PVH) was prominent among patients with BM, contrasted with those without BM (p = 0.001).
• In a multivariate analysis, patients with adenocarcinoma (95% confidence interval [CI] 1.8–171.8) and small cell carcinoma (95% CI 1.4–172.4) respectively developed BM at 9.3- and 8.8-fold higher rates as compared to those with squamous cell carcinoma.
• Findings revealed that patients with grade 0 PVH developed BM at a rate 3.5-, 8.6-, and 3.6-fold higher rates than those with grade 1 (95% CI 1.4–9.0), 2 (95% CI 2.4–41.9), and 3 (95% CI 1.02–15.0), respectively.