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E2018. Brain Metastasis: A Review of Imaging Findings and Advanced Modalities
Authors
  1. Anas Saeed Bamashmos; Yale New Haven Health Bridgeport Hospital
  2. Ayah Megahed; Yale New Haven Health Bridgeport Hospital
  3. Kareem Elfatairy; Yale New Haven Health Bridgeport Hospital
  4. Ashkan Heshmatzadeh Behzadi; Yale New Haven Health Bridgeport Hospital
  5. Rahul Hegde; Yale New Haven Health Bridgeport Hospital
  6. Volodymyr Statsevych; Cleveland Clinic Foundation
Background
Brain metastases account for more than one-half of the central nervous system malignant tumors (1). Imaging is a cornerstone in the management of brain metastases starting from screening for brain lesions in patients with known cancers to diagnosing brain metastases in patients with unknown primary tumors. Among brain metastases, around 30-40% of patients are asymptomatic which reflects the importance of radiological studies in detecting the non-visible part of this iceberg.

Educational Goals / Teaching Points
After participating in this educational exhibit, the learner will get familiar with the spectrum of imaging findings of brain metastases on CT and MRI and the key components behind monitoring and anticipating treatment responses or complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
• Different imaging appearances of brain metastases on CT and MRI, including their local complications. • Advanced techniques such as: and diffusion tensor imaging (DTI), proton magnetic resonance Spectroscopy (MRS) and MR perfusion to diagnose and/or differentiate between brain metastases and other lesions such as high-grade gliomas or lymphomas. • Key points in The Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM). • Future role of imaging in the diagnosis of brain metastases and the novel modalities including advancement in radiomics.

Conclusion
Brain metastases are quite common in the practice of neuroimaging and they have a wide variety of radiological features. The advancement in the management of these lesions in addition to the establishment of comprehensive molecular profiles can serve as a guide for radiologists in identifying and predicting the outcomes of the treatments.