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Brain metastases from small cell lung cancer and non-small cell lung cancer: comparison of spatial distribution and identification of metastatic risk regions

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Abstract

Purpose

This study aims to investigate the spatial distribution difference of brain metastases (BM) between small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) and to identify the metastatic risk in brain regions.

Methods

T1-enhanced MR images of 2997 BM from 728 eligible patients with SCLC and NSCLC were retrospectively reviewed by three independent medical institutions in China. All images were spatially normalised according to the Montreal Neurological Institute space, following BM delineation confirmed by three senior radiologists. The brain regions in the normalised images were identified based on the merged Anatomical Automatic Labeling atlas, and all BM locations were mapped onto these brain regions. Two-tailed proportional hypothesis testing was used to compare the BM observed rate with the expected rate based on the region’s volume, and metastatic risk regions were finally identified.

Results

In SCLC and NSCLC, BM was mainly present in the deep white matter (22.51% and 17.96%, respectively), cerebellar hemisphere (9.84% and 7.46%, respectively) and middle frontal gyrus (6.72% and 7.97%, respectively). The cerebellar hemisphere was a high-risk brain region in the SCLC. The precentral gyrus, middle frontal gyrus, paracentral lobule and cerebellar hemisphere were high-risk BM in the NSCLC. The inferior frontal gyrus and the temporal pole were a low-risk brain region in the SCLC and NSCLC, respectively.

Conclusion

The spatial BM distribution between SCLC and NSCLC is similar. Several critical brain regions had relatively low BM frequency in both SCLC and NSCLC, where a low-dose radiation distribution can be delivered due to adequate preoperative evaluations.

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Data availability

The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the Key Research and Development Program of Shandong Province (Grant Number: 2021SFGC0104), Key Research and Development Program of Jiangsu Province (Grant Number: BE2021663), China Postdoctoral Science Foundation (Grant Number: 2022M712332), Science and Technology Project of Suzhou (Grant Number: SJC2021014), Natural Science Foundation of Shandong Province (Grant Numbers: ZR2022QF071, ZR2022QF099), National Natural Science Foundation of China (Grant Numbers: 81872475, 81372413), Shandong Key Research and Development Plan (Grant Numbers: 2017CXGC1209, 2017GSF18164), Outstanding Youth Natural Science Foundation of Shandong Province (Grant Number: JQ201423), Clinical Medicine Science and Technology Innovation Plan of Jinan (Grant Number: 201704095), and National Key Research and Development Program of China (Grant Number: 2016YFC0904700).

Author information

Author notes

  1. Wei Shi, Yong Wang and Wei Xia are primary authors and contributed equally.

Authors and Affiliations

  1. Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, No. 88 Keling Road, Suzhou New District, Suzhou, 215163, Jiangsu, China

    Wei Shi, Wei Xia & Xin Gao

  2. Jinan Guoke Medical Engineering and Technology Development Co., Ltd., Pharmaceutical Valley New Drug Creation Platform, No. 3 Building, Jinan New District, Jinan, 250101, Shandong, China

    Wei Shi, Wei Xia & Xin Gao

  3. Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

    Yong Wang, Meng Ni, Yujun Bai & Shuanghu Yuan

  4. Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China

    Yong Wang, Meng Ni, Yujun Bai & Shuanghu Yuan

  5. Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China

    Baoyan Liu

  6. Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China

    Jingyi Shen

  7. Linyi People’s Hospital, Linyi, Shandong, China

    Guixiang Weng

  8. Liaocheng People’s Hospital, Liaocheng, Shandong, China

    Wenju Liu

Authors
  1. Wei Shi
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Contributions

All authors contributed to the study conception and design. Study design, data acquisition: YW, BL, MN, GW, SY, XG. Patient sample collection: YW, BL, MN, JS, YB, WL. Data analysis: WS, YW, WX, XG. Drafted manuscript: WS, YW, XG. All authors read and approved the manuscript.

Corresponding authors

Correspondence to Shuanghu Yuan or Xin Gao.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Not applicable.

Ethical approval

This study was approved by the ethics committee of each participating hospital.

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Shi, W., Wang, Y., Xia, W. et al. Brain metastases from small cell lung cancer and non-small cell lung cancer: comparison of spatial distribution and identification of metastatic risk regions. J Neurooncol 161, 97–105 (2023). https://doi.org/10.1007/s11060-022-04211-4

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  • DOI: https://doi.org/10.1007/s11060-022-04211-4

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