What is the role of neuraxis imaging in the workup of brain metastasis?

Updated: Aug 01, 2018
  • Author: Victor Tse, MD, PhD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Head CT imaging of the brain is not as reliable as MRI in determining the extent of brain metastases.

Head CT can cause underestimation of the number of brain lesions. In 20% of cases and even when contrast medium is used, head CT shows a solitary lesion but subsequent MRI shows multiple lesions.

High-resolution MRI can be used to detect additional brain metastases in patients undergoing Gamma Knife surgery. [9]

Contrast medium enhances visualization of mass lesions in the brain and should be used in both CT and MRI.

Newer imaging modalities, such as magnetization transfer imaging and perfusion imaging, are not particularly useful.


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