If someone has lung cancer that has spread to the brain can you tell with an MRI!


Question:

If someone has lung cancer that has spread to the brain can you tell with an MRI?


Answers:

CT scans can detect if there is a reasonably large ("mass effect") tumor up there.

MRI can detect more subtle signs, such as inflammation caused by tumor cell invasion of brain tissues.

Also, there are two cancer syndromes that often have no signs on MRI, CT, or any other imaging studies. One is paraneoplastic encephalomyelitis (don't try and say that all in one breath; I prefer "PNEM" myself). PNEM is technically not a cancer to the brain, it's an autoimmune reaction to the cancer, and the reaction also travels to the brain and wreaks havoc there. PNEM occurs most commonly in "small-cell" lung cancers. It is diagnosable largely by blood tests, and obviously a red flag is raised in patients with SC lung cancer if they show neurological symptoms.

The other imaging-silent cancer complication is leptomeningeal carcinomatosis (LC), which is when cancer cells end up in the meninges (cushions) surrounding your brain. Often, the tumor cell invasion is so diffuse that no imaging can pick it up. It is a late stage cancer symptom, and by this time, patients may die sooner of the original cancer than they would of brain symptoms. Blood tests may detect an invisible LC situation, but diagnosis is based more frequently on the presence of neurological symptoms in late-stage non-brain cancer patients who have cancers other than SC lung.




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