Mapping Distribution of Brain Metastases: Does the Primary Tumor Matter?

Overview

Journal J Neurooncol

Publisher Springer

Date 2020 Feb 18

PMID 32065345

Citations 32

Authors

T Schroeder

P Bittrich

J F Kuhne

C Noebel

H Leischner

J Fiehler

J Schroeder

G Schoen

S Gellissen

Affiliations

Soon will be listed here.

Abstract

Purpose: Prior reports on the location and sizes of brain metastases almost entirely focus on patients with primary breast and pulmonary cancer. This is the first study comparing multiple other types of cancer that metastasize to the brain.

Methods: This monocentric retrospective study includes 369 untreated patients with 3313 intraaxial brain metastases. Following semi-manual segmentation of metastases on post-contrast T1WI, cumulative spatial probability distribution maps of brain metastases were created for the whole group and for all primary tumors. Furthermore, mixed effects logistic regression model analysis was performed to determine if the primary tumor, patient age, and patient sex influence lesion location.

Results: The cerebellum as location of brain metastases was proportionally overrepresented. Breast and pulmonary cancer caused higher number of brain metastases to what would normally be expected. Multivariate analyses revealed a significant accumulation of brain metastases from skin cancer in a frontal and from breast and gastrointestinal cancer in a cerebellar location.

Conclusion: Distribution of brain metastases is very heterogeneous for the distinct primaries, possibly reflecting the diversity of mechanisms involved in brain metastases formation. In daily clinical practice distribution patters may be beneficial to predict the primary cancer site, if unknown.

Citing Articles

Spatial-demographic analysis model for brain metastases distribution.

Zhang L, Che T, Xin B, Li S, Gong G, Wang X Radiol Med. 2025; 130(3):397-411.

PMID: 40019681 PMC: 11903647. DOI: 10.1007/s11547-025-01965-5.

Improved detection of brain metastases using contrast-enhanced 3D black-blood TSE sequences compared to post-contrast 3D T1 GRE: a comparative study on 1.5-T MRI.

Chen Zhou Z, Salvador Alvarez E, Hilario A, Cardenas Del Carre A, Romero Coronado J, Lechuga C Eur Radiol. 2025; .

PMID: 39841203 DOI: 10.1007/s00330-025-11363-0.

The Spatial Distribution of Brain Metastasis Is Determined by the Heterogeneity of the Brain Microenvironment.

Bao H, Ren P, Liang X, Lai J, Bai Y, Liu Y Hum Brain Mapp. 2024; 45(18):e70103.

PMID: 39720836 PMC: 11669001. DOI: 10.1002/hbm.70103.

Current preclinical models of brain metastasis.

Drouin Z, Levesque F, Mouzakitis K, Labrie M Clin Exp Metastasis. 2024; 42(1):5.

PMID: 39694975 DOI: 10.1007/s10585-024-10318-x.

ACSS2 regulates ferroptosis in an E2F1-dependent manner in breast cancer brain metastatic cells.

Esquea E, Young R, Ciraku L, Merzy J, Ahmed N, Talarico A bioRxiv. 2024; .

PMID: 39484430 PMC: 11526985. DOI: 10.1101/2024.10.18.619082.

References

Ostrom Q, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J . CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro Oncol. 2014; 16 Suppl 4:iv1-63. PMC: 4193675. DOI: 10.1093/neuonc/nou223. View

Kienast Y, von Baumgarten L, Fuhrmann M, Klinkert W, Goldbrunner R, Herms J . Real-time imaging reveals the single steps of brain metastasis formation. Nat Med. 2009; 16(1):116-22. DOI: 10.1038/nm.2072. View

Lagerwaard F, Levendag P, Nowak P, Eijkenboom W, Hanssens P, Schmitz P . Identification of prognostic factors in patients with brain metastases: a review of 1292 patients. Int J Radiat Oncol Biol Phys. 1999; 43(4):795-803. DOI: 10.1016/s0360-3016(98)00442-8. View

Hengel K, Sidhu G, Choi J, Weedon J, Nwokedi E, Axiotis C . Attributes of brain metastases from breast and lung cancer. Int J Clin Oncol. 2012; 18(3):396-401. DOI: 10.1007/s10147-012-0392-x. View

Stark A, Stohring C, Hedderich J, Held-Feindt J, Mehdorn H . Surgical treatment for brain metastases: Prognostic factors and survival in 309 patients with regard to patient age. J Clin Neurosci. 2010; 18(1):34-8. DOI: 10.1016/j.jocn.2010.03.046. View

Schneider T, Kemmling A, Schroeder J, Pantel K, Glatzel M, Schoen G . Inverse Perfusion Requirements of Supra- and Infratentorial Brain Metastases Formation. Front Neurol. 2018; 9:391. PMC: 5989059. DOI: 10.3389/fneur.2018.00391. View

McTyre E, Scott J, Chinnaiyan P . Whole brain radiotherapy for brain metastasis. Surg Neurol Int. 2013; 4(Suppl 4):S236-44. PMC: 3656558. DOI: 10.4103/2152-7806.111301. View

Gavrilovic I, Posner J . Brain metastases: epidemiology and pathophysiology. J Neurooncol. 2005; 75(1):5-14. DOI: 10.1007/s11060-004-8093-6. View

Robb R . The biomedical imaging resource at Mayo Clinic. IEEE Trans Med Imaging. 2001; 20(9):854-67. DOI: 10.1109/42.952724. View

10.

Delattre J, Krol G, Thaler H, Posner J . Distribution of brain metastases. Arch Neurol. 1988; 45(7):741-4. DOI: 10.1001/archneur.1988.00520310047016. View

11.

Berk B, Nagel S, Hering K, Paschke S, Hoffmann K, Kortmann R . White matter lesions reduce number of brain metastases in different cancers: a high-resolution MRI study. J Neurooncol. 2016; 130(1):203-209. DOI: 10.1007/s11060-016-2235-5. View

12.

Takano K, Kinoshita M, Takagaki M, Sakai M, Tateishi S, Achiha T . Different spatial distributions of brain metastases from lung cancer by histological subtype and mutation status of epidermal growth factor receptor. Neuro Oncol. 2015; 18(5):716-24. PMC: 4827044. DOI: 10.1093/neuonc/nov266. View

13.

Bakker E, Bacskai B, Arbel-Ornath M, Aldea R, Bedussi B, Morris A . Lymphatic Clearance of the Brain: Perivascular, Paravascular and Significance for Neurodegenerative Diseases. Cell Mol Neurobiol. 2016; 36(2):181-94. PMC: 4844641. DOI: 10.1007/s10571-015-0273-8. View

14.

WALKER A, Robins M, Weinfeld F . Epidemiology of brain tumors: the national survey of intracranial neoplasms. Neurology. 1985; 35(2):219-26. DOI: 10.1212/wnl.35.2.219. View

15.

Tabouret E, Chinot O, Metellus P, Tallet A, Viens P, Goncalves A . Recent trends in epidemiology of brain metastases: an overview. Anticancer Res. 2012; 32(11):4655-62. View

16.

Barnholtz-Sloan J, Sloan A, Davis F, Vigneau F, Lai P, Sawaya R . Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol. 2004; 22(14):2865-72. DOI: 10.1200/JCO.2004.12.149. View

17.

Counsell C, Collie D, Grant R . Incidence of intracranial tumours in the Lothian region of Scotland, 1989-90. J Neurol Neurosurg Psychiatry. 1996; 61(2):143-50. PMC: 1073987. DOI: 10.1136/jnnp.61.2.143. View

18.

Fabi A, Felici A, Metro G, Mirri A, Bria E, Telera S . Brain metastases from solid tumors: disease outcome according to type of treatment and therapeutic resources of the treating center. J Exp Clin Cancer Res. 2011; 30:10. PMC: 3033846. DOI: 10.1186/1756-9966-30-10. View

19.

Parker G, Harnsberger H . Clinical-radiologic issues in perineural tumor spread of malignant diseases of the extracranial head and neck. Radiographics. 1991; 11(3):383-99. DOI: 10.1148/radiographics.11.3.1852933. View

20.

Smedby K, Brandt L, Backlund M, Blomqvist P . Brain metastases admissions in Sweden between 1987 and 2006. Br J Cancer. 2009; 101(11):1919-24. PMC: 2788258. DOI: 10.1038/sj.bjc.6605373. View