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White matter lesions reduce number of brain metastases in different cancers: a high-resolution MRI study

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Abstract

Brain metastases are major complications of common cancers. Tumor type and proneness to the CNS are thought to define the number and size of brain metastases. It is not known if intrinsic vascular factors can also have an effect. Restricted perfusion due to cerebral small vessel disease is frequent in elderly patients and causes white matter lesions (WML). The aim of this analysis was to evaluate a possible negative effect of WML and patient age on the number and size of brain metastases (BM) of different tumor entities. Pre-therapeutic 3 T brain magnetic resonance imaging (MRI) of 200 patients with BM were analyzed. Location, size and number of BM (NoM) were determined. T2 hyperintensive WML were scored according to Fazekas-Score (grade I–III). Patients with WML grade 1 (NoM: 5.59; p = 0.009) and grade 2 (NoM: 3.68; p = 0.002) had significantly less BM than patients without WML (NoM: 6.99). This effect was present in subgroups of different tumors: NSCLC (p = 0.05), other tumors than NSCLC (p = 0.048). Age (≤65 or >65 years) was positively correlated with the degree of WML but not with number (pNoM = 0.832) or mean diameter (pmDM = 0.662) of brain metastases. While patient age did not appear to be relevant, increasing WML were associated with lower number of brain metastases in different tumor types.

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Acknowledgments

B.A.B was recipient of a merit-based doctoral scholarship from the Hans-Böckler Foundation funded by the Federal Ministry of Education and Research—Germany (BMBF).

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    Authors and Affiliations

    1. Klinik für Radioonkologie und Strahlentherapie, Universitätsklinikum Leipzig AöR, Dr. med. Clemens Seidel, Stephanstraße 9 a, 04103, Leipzig, Germany

      Benjamin-Andreas Berk, Sandra Nagel, K. Hering, S. Paschke, Rolf-Dieter Kortmann & Clemens Seidel

    2. Abteilung für Neuroradiologie, Universitätsklinikum Leipzig, Leipzig, Germany

      Karl-Titus Hoffmann

    3. Abteilung für Neuroradiologie, Universitätsklinik Heidelberg, Heidelberg, Germany

      Chiara Gaudino

    4. Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, UK

      Benjamin-Andreas Berk

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    1. Benjamin-Andreas Berk
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    Benjamin-Andreas Berk and Sandra Nagel are co-first authors.

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    Berk, BA., Nagel, S., Hering, K. et al. White matter lesions reduce number of brain metastases in different cancers: a high-resolution MRI study. J Neurooncol 130, 203–209 (2016). https://doi.org/10.1007/s11060-016-2235-5

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    • DOI: https://doi.org/10.1007/s11060-016-2235-5

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