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Melanoma brain metastases: correlation of imaging features with genomic markers and patient survival

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Abstract

Purpose To identify MR imaging features of melanoma brain metastases (MBM) that correlate with genetic profile of melanoma and patient survival. Materials and methods Patients with newly diagnosed melanoma metastases were identified from institutional database A retrospective review of brain MRI was performed focusing on lesion number, size, T1-, T2- and diffusion-weighted signal characteristics, hemorrhage, necrosis, enhancement pattern and edema. Genomic (BRAF status), treatment and survival data was collected. Results 98 patients were included in final analysis. A strong correlation was found between size of the largest lesion and the percent of lesions with T1-weighted hyperintense signal (R = 0.49), percent of lesions with size >1 cm (0.55), and the lesions that are clearly hemorrhagic (0.43). The analyzed imaging parameters were found to be independent of BRAF mutation status. The median survival of subjects with single lesion (9.1 months) was significantly higher than the median survival of subjects with more than 1 lesion (4.9 months) (p = 0.002). Patients with 2–18 lesions had significantly longer survival (5.6 months) than with >18 lesions (2 months) (p < 0.001). Other imaging parameters such as lesion size, T1-weighted hyperintensity, number of lesions with edema and hemorrhage were not found to be significantly related to survival. BRAF inhibitor treatment was found to be the most significant prognostic factor (p = 0.002) among patients with multiple lesions. Conclusion There is a statistically significant correlation between number of brain metastases and survival. In patients with multiple lesions, BRAF inhibitor treatment was the most significant prognostic factor.

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    Authors and Affiliations

    1. Department of Radiology, Winthrop-University Hospital, 259 First St., Mineola, NY, 11501, USA

      Ritu Bordia

    2. Department of Population Health, NYU School of Medicine, New York, NY, USA

      Hua Zhong

    3. Department of Family Medicine, St. Josephs’s Medical Center, Yonkers, NY, USA

      Joon Lee

    4. Department of Medical Oncology, Yale Cancer Center, New Haven, CT, USA

      Sarah Weiss

    5. School of Industrial Management Engineering, Korea University, Seoul, Republic of Korea

      Sung Won Han

    6. Departments of Dermatology, Medicine and Urology, NYU School of Medicine, New York, NY, USA

      Iman Osman

    7. Department of Radiology, NYU School of Medicine, New York, NY, USA

      Rajan Jain

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    1. Ritu Bordia
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    2. Hua Zhong
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    Correspondence to Ritu Bordia.

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    Ritu Bordia and Hua Zhong are co-first authors with equal contribution.

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    Bordia, R., Zhong, H., Lee, J. et al. Melanoma brain metastases: correlation of imaging features with genomic markers and patient survival. J Neurooncol 131, 341–348 (2017). https://doi.org/10.1007/s11060-016-2305-8

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    • DOI: https://doi.org/10.1007/s11060-016-2305-8

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