Screening for brain metastases in patients with stage III non–small-cell lung cancer, magnetic resonance imaging or computed tomography? A prospective study

Janna Schoenmaekers; Paul Hofman; Gerben Bootsma; Marcel Westenend; Machiel de Booij; Wendy Schreurs; Ruud Houben; Dirk De Ruysscher; Anne Marie Dingemans; Lizza E.L. Hendriks

doi:10.1016/j.ejca.2019.04.017

Screening for brain metastases in patients with stage III non–small-cell lung cancer, magnetic resonance imaging or computed tomography? A prospective study

Janna Schoenmaekers, Paul Hofman, Gerben Bootsma, Marcel Westenend, Machiel de Booij, Wendy Schreurs, Ruud Houben, Dirk De Ruysscher, Anne Marie Dingemans, Lizza E.L. Hendriks^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

32 Citations (Scopus)

Abstract

Introduction:

Non–small-cell lung cancer (NSCLC) guidelines advise to screen stage III NSCLC patients for brain metastases (BMs), preferably by magnetic resonance imaging (MRI) or when contraindicated or not accessible a dedicated contrast enhanced–computed tomography (dCE-CT), which can be incorporated in the staging ¹⁸Fluodeoxoglucose–positron emission tomography (¹⁸FDG-PET-CE-CT). In daily practice, often a dCE-CT is performed instead of a MRI. The aim of the current study is to evaluate the additive value of MRI after dCE-CT, incorporated in the ¹⁸FDG-PET-CE-CT.

Patients and methods:

It is an observational prospective multicentre study (NTR3628). Inclusion criteria included stage III NSCLC patients with a dCE-CT of the brain incorporated in the ¹⁸FDG-PET and an additional MRI of the brain. Primary end-point is percentage of patients with BM on MRI without suspect lesions on dCE-CT. Secondary end-points are percentage of patients with BM on dCE-CT and percentage of patients with BM ≤ 1 year of a negative staging MRI.

Results:

Sixteen (7%) patients with extracranial stage III had BM on dCE-CT and were excluded. One hundred forty-nine patients were enrolled. 7/149 (4.7%) had BM on MRI without suspect lesions on dCE-CT. One hundred eighteen patients had a follow-up of at least 1 year (four with BM on baseline MRI); eight of the remaining 114 (7%) patients developed BM ≤ 1 year after a negative staging brain MRI.

Conclusion:

Although in 7% of otherwise stage III NSCLC patients, BMs were detected on staging dCE-CT, MRI brain detected BMs in an additional 4.7%, which we consider clinically relevant. Within 1 year after a negative staging MRI, 7% developed BM.

Original language	English
Pages (from-to)	88-96
Number of pages	9
Journal	European Journal of Cancer
Volume	115
DOIs	https://doi.org/10.1016/j.ejca.2019.04.017
Publication status	Published - Jul 2019
Externally published	Yes

Bibliographical note

Funding Information:
L.H. has none related to current manuscript, and outside of current manuscript, L.H. received research funding from Roche and Boehringer Ingelheim (both institution) and is in advisory board of Boehringer and BMS (both institution, BMS also self) and received travel reimbursement from Roche, BMS (self), took part mentorship program with key opinion leaders funded by AstraZeneca and received fees for educational webinars: Quadia (self). All other authors have none to declare.

Publisher Copyright:
© 2019 Elsevier Ltd

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10.1016/j.ejca.2019.04.017

Cite this

Schoenmaekers, J., Hofman, P., Bootsma, G., Westenend, M., de Booij, M., Schreurs, W., Houben, R., De Ruysscher, D., Dingemans, A. M., & Hendriks, L. E. L. (2019). Screening for brain metastases in patients with stage III non–small-cell lung cancer, magnetic resonance imaging or computed tomography? A prospective study. European Journal of Cancer, 115, 88-96. https://doi.org/10.1016/j.ejca.2019.04.017

@article{6815be5b20b6476799dc785d8a2bb35e,

title = "Screening for brain metastases in patients with stage III non–small-cell lung cancer, magnetic resonance imaging or computed tomography? A prospective study",

abstract = "Introduction:Non–small-cell lung cancer (NSCLC) guidelines advise to screen stage III NSCLC patients for brain metastases (BMs), preferably by magnetic resonance imaging (MRI) or when contraindicated or not accessible a dedicated contrast enhanced–computed tomography (dCE-CT), which can be incorporated in the staging 18Fluodeoxoglucose–positron emission tomography (18FDG-PET-CE-CT). In daily practice, often a dCE-CT is performed instead of a MRI. The aim of the current study is to evaluate the additive value of MRI after dCE-CT, incorporated in the 18FDG-PET-CE-CT. Patients and methods: It is an observational prospective multicentre study (NTR3628). Inclusion criteria included stage III NSCLC patients with a dCE-CT of the brain incorporated in the 18FDG-PET and an additional MRI of the brain. Primary end-point is percentage of patients with BM on MRI without suspect lesions on dCE-CT. Secondary end-points are percentage of patients with BM on dCE-CT and percentage of patients with BM ≤ 1 year of a negative staging MRI. Results: Sixteen (7\%) patients with extracranial stage III had BM on dCE-CT and were excluded. One hundred forty-nine patients were enrolled. 7/149 (4.7\%) had BM on MRI without suspect lesions on dCE-CT. One hundred eighteen patients had a follow-up of at least 1 year (four with BM on baseline MRI); eight of the remaining 114 (7\%) patients developed BM ≤ 1 year after a negative staging brain MRI. Conclusion: Although in 7\% of otherwise stage III NSCLC patients, BMs were detected on staging dCE-CT, MRI brain detected BMs in an additional 4.7\%, which we consider clinically relevant. Within 1 year after a negative staging MRI, 7\% developed BM.",

author = "Janna Schoenmaekers and Paul Hofman and Gerben Bootsma and Marcel Westenend and \{de Booij\}, Machiel and Wendy Schreurs and Ruud Houben and \{De Ruysscher\}, Dirk and Dingemans, \{Anne Marie\} and Hendriks, \{Lizza E.L.\}",

note = "Funding Information: L.H. has none related to current manuscript, and outside of current manuscript, L.H. received research funding from Roche and Boehringer Ingelheim (both institution) and is in advisory board of Boehringer and BMS (both institution, BMS also self) and received travel reimbursement from Roche, BMS (self), took part mentorship program with key opinion leaders funded by AstraZeneca and received fees for educational webinars: Quadia (self). All other authors have none to declare. Publisher Copyright: {\textcopyright} 2019 Elsevier Ltd",

year = "2019",

month = jul,

doi = "10.1016/j.ejca.2019.04.017",

language = "English",

volume = "115",

pages = "88--96",

journal = "European Journal of Cancer",

issn = "0959-8049",

publisher = "Elsevier Ltd.",

}

Schoenmaekers, J, Hofman, P, Bootsma, G, Westenend, M, de Booij, M, Schreurs, W, Houben, R, De Ruysscher, D , Dingemans, AM & Hendriks, LEL 2019, 'Screening for brain metastases in patients with stage III non–small-cell lung cancer, magnetic resonance imaging or computed tomography? A prospective study', European Journal of Cancer, vol. 115, pp. 88-96. https://doi.org/10.1016/j.ejca.2019.04.017

TY - JOUR

T1 - Screening for brain metastases in patients with stage III non–small-cell lung cancer, magnetic resonance imaging or computed tomography? A prospective study

AU - Schoenmaekers, Janna

AU - Hofman, Paul

AU - Bootsma, Gerben

AU - Westenend, Marcel

AU - de Booij, Machiel

AU - Schreurs, Wendy

AU - Houben, Ruud

AU - De Ruysscher, Dirk

AU - Dingemans, Anne Marie

AU - Hendriks, Lizza E.L.

N1 - Funding Information: L.H. has none related to current manuscript, and outside of current manuscript, L.H. received research funding from Roche and Boehringer Ingelheim (both institution) and is in advisory board of Boehringer and BMS (both institution, BMS also self) and received travel reimbursement from Roche, BMS (self), took part mentorship program with key opinion leaders funded by AstraZeneca and received fees for educational webinars: Quadia (self). All other authors have none to declare. Publisher Copyright: © 2019 Elsevier Ltd

PY - 2019/7

Y1 - 2019/7

N2 - Introduction:Non–small-cell lung cancer (NSCLC) guidelines advise to screen stage III NSCLC patients for brain metastases (BMs), preferably by magnetic resonance imaging (MRI) or when contraindicated or not accessible a dedicated contrast enhanced–computed tomography (dCE-CT), which can be incorporated in the staging 18Fluodeoxoglucose–positron emission tomography (18FDG-PET-CE-CT). In daily practice, often a dCE-CT is performed instead of a MRI. The aim of the current study is to evaluate the additive value of MRI after dCE-CT, incorporated in the 18FDG-PET-CE-CT. Patients and methods: It is an observational prospective multicentre study (NTR3628). Inclusion criteria included stage III NSCLC patients with a dCE-CT of the brain incorporated in the 18FDG-PET and an additional MRI of the brain. Primary end-point is percentage of patients with BM on MRI without suspect lesions on dCE-CT. Secondary end-points are percentage of patients with BM on dCE-CT and percentage of patients with BM ≤ 1 year of a negative staging MRI. Results: Sixteen (7%) patients with extracranial stage III had BM on dCE-CT and were excluded. One hundred forty-nine patients were enrolled. 7/149 (4.7%) had BM on MRI without suspect lesions on dCE-CT. One hundred eighteen patients had a follow-up of at least 1 year (four with BM on baseline MRI); eight of the remaining 114 (7%) patients developed BM ≤ 1 year after a negative staging brain MRI. Conclusion: Although in 7% of otherwise stage III NSCLC patients, BMs were detected on staging dCE-CT, MRI brain detected BMs in an additional 4.7%, which we consider clinically relevant. Within 1 year after a negative staging MRI, 7% developed BM.

AB - Introduction:Non–small-cell lung cancer (NSCLC) guidelines advise to screen stage III NSCLC patients for brain metastases (BMs), preferably by magnetic resonance imaging (MRI) or when contraindicated or not accessible a dedicated contrast enhanced–computed tomography (dCE-CT), which can be incorporated in the staging 18Fluodeoxoglucose–positron emission tomography (18FDG-PET-CE-CT). In daily practice, often a dCE-CT is performed instead of a MRI. The aim of the current study is to evaluate the additive value of MRI after dCE-CT, incorporated in the 18FDG-PET-CE-CT. Patients and methods: It is an observational prospective multicentre study (NTR3628). Inclusion criteria included stage III NSCLC patients with a dCE-CT of the brain incorporated in the 18FDG-PET and an additional MRI of the brain. Primary end-point is percentage of patients with BM on MRI without suspect lesions on dCE-CT. Secondary end-points are percentage of patients with BM on dCE-CT and percentage of patients with BM ≤ 1 year of a negative staging MRI. Results: Sixteen (7%) patients with extracranial stage III had BM on dCE-CT and were excluded. One hundred forty-nine patients were enrolled. 7/149 (4.7%) had BM on MRI without suspect lesions on dCE-CT. One hundred eighteen patients had a follow-up of at least 1 year (four with BM on baseline MRI); eight of the remaining 114 (7%) patients developed BM ≤ 1 year after a negative staging brain MRI. Conclusion: Although in 7% of otherwise stage III NSCLC patients, BMs were detected on staging dCE-CT, MRI brain detected BMs in an additional 4.7%, which we consider clinically relevant. Within 1 year after a negative staging MRI, 7% developed BM.

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U2 - 10.1016/j.ejca.2019.04.017

DO - 10.1016/j.ejca.2019.04.017

M3 - Article

C2 - 31129385

AN - SCOPUS:85065918118

SN - 0959-8049

VL - 115

SP - 88

EP - 96

JO - European Journal of Cancer

JF - European Journal of Cancer

ER -

Screening for brain metastases in patients with stage III non–small-cell lung cancer, magnetic resonance imaging or computed tomography? A prospective study

Abstract

Bibliographical note

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