Asymptomatic brain metastases (BM) in small cell lung cancer (SCLC): MR-imaging is useful at initial diagnosis

J Neurooncol. 2000 Jul;48(3):243-8. doi: 10.1023/a:1006427407281.


Purpose: In this study we evaluated the usefulness of MR-imaging in the detection of asymptomatic brain metastases (BM) at the initial diagnosis in patients with small cell lung cancer (SCLC) and studied the follow-up of these patients.

Patients and methods: One-hundred and twenty-five patients with SCLC were investigated with MR-imaging.

Results: In 112 patients with normal neurological findings, MR-imaging of the brain demonstrated BM in 17 patients (15%). Six of these 17 patients were therefore upgraded to extensive disease (ED). Two of these 17 patients died during chemotherapy because of progressive disease and 3 patients became neurologic symptomatic with progressive disease on MR-imaging of the brain. After completion of chemotherapy a repeated MR-imaging of the brain in the remaining 12 patients showed 1 complete remission, 4 partial remission and 7 progressive disease of the BM.

Conclusion: This study showed that at presentation an unexpectedly high percentage of SCLC patients had asymptomatic BM on MR-imaging. We propose that MR-imaging of the brain should be included in the staging of SCLC patients as well for staging, prognosis and therapy.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Brain Neoplasms / diagnosis*
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / mortality
  • Brain Neoplasms / secondary*
  • Carcinoma, Small Cell / diagnosis
  • Carcinoma, Small Cell / drug therapy
  • Carcinoma, Small Cell / mortality
  • Carcinoma, Small Cell / secondary*
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Etoposide / administration & dosage
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Magnetic Resonance Imaging
  • Radiography
  • Reproducibility of Results
  • Retrospective Studies
  • Survival Analysis
  • Time Factors


  • Etoposide
  • Doxorubicin
  • Cyclophosphamide