Chen Bihong T, Jin Taihao, Ye Ningrong, Chen Sean W, Rockne Russell C, Yoon Stephanie, Mambetsariev Isa, Daniel Ebenezer, Salgia Ravi
Department of Diagnostic Radiology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA 91010, USA.
Brain Sci. 2023 Jul 11;13(7):1057. doi: 10.3390/brainsci13071057.
Non-small cell lung cancer (NSCLC) has a high rate of brain metastasis. The purpose of this study was to assess the differential distribution of brain metastases from primary NSCLC based on mutation status. Brain MRI scans of patients with brain metastases from primary NSCLC were retrospectively analyzed. Brain metastatic tumors were grouped according to mutation status of their primary NSCLC and the neuroimaging features of these brain metastases were analyzed. A total of 110 patients with 1386 brain metastases from primary NSCLC were included in this study. Gray matter density at the tumor center peaked at ~0.6 for all mutations. The median depths of tumors were 7.9 mm, 8.7 mm and 9.1 mm for EGFR, ALK and KRAS mutation groups, respectively ( = 0.044). Brain metastases for the EGFR mutation-positive group were more frequently located in the left cerebellum, left cuneus, left precuneus and right precentral gyrus. In the ALK mutation-positive group, brain metastases were more frequently located in the right middle occipital gyrus, right posterior cingulate, right precuneus, right precentral gyrus and right parietal lobe. In the KRAS mutation-positive patient group, brain metastases were more frequently located in the posterior left cerebellum. Our study showed differential spatial distribution of brain metastases in patients with NSCLC according to their mutation status. Information regarding distribution of brain metastases is clinically relevant as it could be helpful to guide treatment planning for targeted therapy, and for predicting prognosis.
非小细胞肺癌（NSCLC）脑转移率较高。本研究的目的是基于突变状态评估原发性NSCLC脑转移的差异分布。对原发性NSCLC脑转移患者的脑部MRI扫描进行回顾性分析。根据原发性NSCLC的突变状态对脑转移瘤进行分组，并分析这些脑转移瘤的神经影像学特征。本研究共纳入110例原发性NSCLC脑转移患者，共1386个脑转移灶。所有突变类型的肿瘤中心灰质密度在~0.6时达到峰值。EGFR、ALK和KRAS突变组肿瘤的中位深度分别为7.9 mm、8.7 mm和9.1 mm（ = 0.044）。EGFR突变阳性组的脑转移灶更常见于左侧小脑、左侧楔叶、左侧楔前叶和右侧中央前回。ALK突变阳性组的脑转移灶更常见于右侧枕中回、右侧后扣带回、右侧楔前叶、右侧中央前回和右侧顶叶。KRAS突变阳性患者组的脑转移灶更常见于左侧小脑后部。我们的研究表明，NSCLC患者的脑转移灶根据其突变状态存在差异空间分布。脑转移灶分布的信息具有临床相关性，因为它有助于指导靶向治疗的治疗计划制定以及预测预后。
