Brain Metastases From Lung Adenocarcinoma May Preferentially Involve the Distal Middle Cerebral Artery Territory and Cerebellum

Abstract

Although whole-brain radiation therapy (WBRT) is the mainstay of treatment for brain metastases (BMs), the concept of saving eloquent cortical lesions has been promoted. If BMs from lung cancer are spatially biased to certain regions, this approach can be justified more. We evaluated whether BMs from lung cancer show a preference for certain brain regions and if their distribution pattern differs according to the histologic subtype of the primary lung cancer. In this retrospective study, 562 BMs in 80 patients were analyzed (107 BMs from small cell carcinoma, 432 from adenocarcinoma, and 23 from squamous cell carcinoma). Kernel density estimation was performed to investigate whether BM spatial patterns differed among lung cancer subtypes. Further, we explored more detailed subregions where BMs from adenocarcinomas occur frequently using one-way analysis of variance. Finally, we divided our cohort into those with fewer (≤10) and more (>10) BMs and evaluated whether this biased pattern was maintained across limited and extensive stages. For small cell carcinoma, BMs were biased to the cerebellum, but this did not reach statistical significance. For adenocarcinoma, BMs were found more frequently near the distal middle cerebral artery (MCA) territory and cerebellum than in other arterial territories ( p < 0.01). The precentral and postcentral gyri were the most significant subregions within the distal anterior cerebral artery (ACA) and MCA territories ( p < 0.01). Crus I and Lobule VI were significant regions within the cerebellum ( p < 0.01). Regardless of the number of BMs, the affinity to the distal MCA territory and cerebellum was maintained. The present data confirm that BMs from lung adenocarcinoma may preferentially involve the distal MCA territory and cerebellum.

Clinico-radiological features of brain metastases from thyroid cancer

“…The majority of BMs were located in the supra-tentorium or spread to the whole brain. The preferential involvement in certain regions has been reported in other primary cancers such as lung cancer and breast cancer [24,25] . Although the mechanism for the preferential involvement of specific brain regions remains unknown, we speculate that the “seed and soil theory” may partially explain it.…”

“…The preferential involvement in certain regions has been reported in other primary cancers such as lung cancer and breast cancer. [ 24 , 25 ] Although the mechanism for the preferential involvement of specific brain regions remains unknown, we speculate that the “seed and soil theory” may partially explain it. The affinity of the tumor to the microenvironment plays a role in the extravasation and colonization of tumor cells at specific sites.…”

Hippocampal Metastasis Rate Based on Non-Small Lung Cancer TNM Stage and Molecular Markers

“…The estimated transform matrix was concatenated with a co-registration transform matrix, and the resultant matrix was applied to 3D T1-weighted SPACE images and binary labeled BM images. The voxel for the center of gravity was localized for each BM, and binary BM masks were regenerated as spheres with a 5-mm radius to consider the origin of the BMs more accurately and to standardize their chronological development ( 25 ).…”

Gangliosides as Biomarkers of Human Brain Diseases: Trends in Discovery and Characterization by High-Performance Mass Spectrometry

“…Left untreated, LADC-derived brain metastases cause death in a few weeks, with almost all patients succumbing because of neurological rather than systemic issues. Surgical resection, stereotactic radiosurgery (SRS), and the gold standard—that is, whole-brain radiation therapy (WBRT)—are currently the primary treatment options for patients suffering from LADC-derived brain metastasis [ 211 , 212 ], although even under treatment, the prognosis is generally poor, with a median survival time between 3 and 6 months.…”