Carolin Gramsch MD, Presenter: Nothing to Disclose

Sophia Goericke, Abstract Co-Author: Nothing to Disclose

Felix Behrens, Abstract Co-Author: Nothing to Disclose

Lisa Zimmer, Abstract Co-Author: Nothing to Disclose

Dirk Schadendorf, Abstract Co-Author: Nothing to Disclose

Andrej Krasny, Abstract Co-Author: Nothing to Disclose

Michael Forsting MD, Abstract Co-Author: Nothing to Disclose

Marc U. Schlamann, Abstract Co-Author: Nothing to Disclose

While staging patients with malignant melanoma, isolated cerebral susceptibility artifacts in T2* weighted/SWI sequences without correlate in contrast based T1-weighted images are often found. Cavernomas, microhemorrhages and melanin-containing metastases without contrast enhancement represent possible differential diagnoses for these findings. The purpose of this study was to find out, how often such lesions correspond to metastases.

Brain MR images (1.5 T) of all 408 patients with malignant melanoma without cerebral metastases in the initial staging by MRI, examined in our department from 2006 till 2009, were reviewed in regard to detection of isolated cerebral susceptibility artifacts. The MR images of all patients (n=18/408, 5♀, 13♂) with signal intensity loss in T2*/SWI and no corresponding lesion in post-contrast T1-weighted imaging were reviewed retrospectively. The average observation period was 19.6 month (6 – 46 month). Additionally we assessed the number of detectable isolated cerebral susceptibility artifacts in 408 patients with lung cancer.

In each of these 18 patients with malignant melanoma between one and seven hypointense lesions in T2*/SWI were found. None of these lesions developed into a metastasis. In even more patients with lung cancer (32/408) these lesions could be detected.

Regarding isolated cerebral susceptibility artifacts in T2*/SWI sequences without correlate in contrast based T1-weighted images differential diagnosis metastasis seems to be subordinated.

Susceptibility weighted imaging in staging patients with malignant melanoma can complement MRI protocols but cannot replace usage of contrast enhanced T1-weighted images.

Gramsch, C, Goericke, S, Behrens, F, Zimmer, L, Schadendorf, D, Krasny, A, Forsting, M, Schlamann, M, Isolated Cerebral Susceptibility Artifacts in Patients with Malignant Melanoma: Metastasis or Not?  .  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12037081.html