Haemorrhage Detection in Brain Metastases of Lung Cancer Patients using Magnetic Resonance Imaging

Abstract

Magnetic resonance susceptibility-weighted imaging (SWI) is a new, highly-sensitive technique used to detect haemorrhage. This study evaluated the ability of magnetic resonance imaging (MRI) to detect haemorrhage in 45 lung cancer patients with brain metastases and compared the results with T2*weighted imaging (T2*WI) and contrast-enhanced T1-weighted imaging (CE-T1WI). Eighty-nine haemorrhagic brain metastases were identified in 31 patients using SWI, 68 were identified in 23 patients using T2*WI and 46 were identified in 14 patients using CE-T1WI. Most micro-bleeds could only be identified by SWI. It was concluded that haemorrhage is a frequent occurrence in brain metastases originating from lung cancer and that haemorrhage can be detected using SWI in a majority of brain metastases patients.

Brain metastases: neuroimaging

“…Thus intrinsic (precontrast) T1 hyperintensity should raise the possibility of a hemorrhagic component (Zhang et al, 2009). Other features of metastases also can result in intrinsic T1 hyperintensity, including melanin, as can be seen in melanoma metastases (Isiklar et al, 1995).…”

Susceptibility-weighted imaging findings of subacute delayed carbon monoxide intoxication: A report of five cases

“…SWIs are useful for showing the iron contents of old cerebral hemorrhages, microbleeds, venous malformations and brain tumors [9,10]. Thus, they are sensitive enough to reflect the deposition of hemosiderin and iron secondary to cerebral hemorrhage [11,12]. In case 1, when compared to the other MR sequences, the SWIs showed mildly low signal intensities in the globus pallidus during the acute stage, but the images obtained during the subacute stage showed definite lower signal intensities in the globus pallidus (Fig.…”

“…These blood breakdown products (deoxyhemoglobin, methemoglobin, hemosiderin, ferritin) are all paramagnetic materials that shorten both the T1 relaxation time due to the paramagnetic dipole-dipole interaction, resulting in high signal intensity in T1WIs, and the T2 relaxation time due to the magnetic susceptibility effect disturbing the homogeneous magnetic field, creating an overall loss of signal-intensity in SWI [16]. Since SWIs have a higher spatial resolution based on their thinner slices and relatively shorter repetition times than other MRI techniques, SWIs are more helpful in the delineation of petechial hemorrhages than T1WIs or T2WIs [8,12].…”

Diagnostic imaging of intracranial metastasis

“…T2*-weighted MR sequences such as gradient-recalled echo (GRE) and susceptibility weighted imaging (SWI) accentuate magnetic field inhomogeneities caused by paramagnetic/ferromagnetic substances in melanin and blood products [14,15]. This characteristic, particularly in the more sensitive SWI sequence, aids in the detection of hemorrhagic and/or melanotic metastases [16][17][18]. T1-weighted post contrast imaging can also be performed using spoiled gradient echo (SPGR) technique allowing for fast performance of thin section imaging (1-2 mm slice thickness) which has been shown to increase detection of metastases, particularly small metastases (< 3 mm), compared to conventional spin echo or fast spin echo T1-weighted imaging [19,20].…”