PMID- 31939701
OWN - NLM
STAT- MEDLINE
DCOM- 20200506
LR  - 20200506
IS  - 1546-3141 (Electronic)
IS  - 0361-803X (Linking)
VI  - 214
IP  - 3
DP  - 2020 Mar
TI  - Diagnostic Value of CT of Chest, Abdomen, and Pelvis in Patients With Solitary 
      and Multiple Brain Lesions.
PG  - 636-640
LID - 10.2214/AJR.19.22051 [doi]
AB  - OBJECTIVE. A common goal in patients with newly discovered brain lesions is to 
      determine if the lesions are primary malignant brain neoplasms, metastases, or 
      benign entities. Such patients often undergo CT of the chest, abdomen, and pelvis 
      (CT CAP) to identify a primary neoplasm that may have metastasized to the brain. 
      The aim of this study is to determine the frequency of finding a primary cancer 
      on CT CAP. MATERIALS AND METHODS. A large academic hospital imaging database was 
      searched for cases of new intracranial lesions with subsequent CT CAP performed 
      for metastatic workup. The frequency of primary neoplasms diagnosed in the chest 
      versus abdominal and pelvic portions of CT scans was determined in patients with 
      newly identified intraaxial and extraaxial brain lesions. Lesion characteristics 
      were recorded including size, number, and the presence of enhancement and 
      hemorrhage. Ancillary signs of an abdominopelvic neoplasm were also recorded. 
      RESULTS. A total of 227 of 287 (79%) cases of newly discovered intracranial 
      lesions were malignant (primary or metastatic) and 60 (21%) were benign. Of the 
      227 malignant cases, 136 (60%) were primary brain neoplasms and 91 (40%) were 
      brain metastases, and 68 of the 91 (75%) lung primary. Chest CT (CTC) identified 
      a primary neoplasm in 65 of 287 (23%) cases; 63 of those 65 (96%) neoplasms arose 
      in the lungs. CT of the abdomen and pelvis (CTAP) identified a primary neoplasm 
      in only 3 of 287 (1%) cases. In 26 cases in which the intracranial lesions did 
      not enhance, only one was metastatic. CONCLUSION. In patients with newly 
      discovered brain lesions, CTC is warranted, but CTAP is unlikely to be useful in 
      patients without ancillary signs of abdominopelvic neoplasm.
FAU - Rothman, Richard K
AU  - Rothman RK
AD  - Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, 20 York 
      St, New Haven, CT 06510.
FAU - Weinreb, Jeffrey
AU  - Weinreb J
AD  - Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, 20 York 
      St, New Haven, CT 06510.
FAU - Zucconi, William
AU  - Zucconi W
AD  - Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, 20 York 
      St, New Haven, CT 06510.
FAU - Malhotra, Ajay
AU  - Malhotra A
AD  - Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, 20 York 
      St, New Haven, CT 06510.
LA  - eng
PT  - Journal Article
DEP - 20200115
PL  - United States
TA  - AJR Am J Roentgenol
JT  - AJR. American journal of roentgenology
JID - 7708173
SB  - IM
MH  - Abdominal Cavity/*diagnostic imaging
MH  - Adult
MH  - Aged
MH  - Brain Neoplasms/*pathology
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis/*diagnostic imaging
MH  - Neoplasms, Multiple Primary/*diagnostic imaging
MH  - Pelvis/*diagnostic imaging
MH  - Retrospective Studies
MH  - Thorax/*diagnostic imaging
MH  - Tomography, X-Ray Computed/*methods
OTO - NOTNLM
OT  - brain
OT  - malignancy
OT  - metastasis
OT  - neoplasm
OT  - workup
EDAT- 2020/01/16 06:00
MHDA- 2020/05/07 06:00
CRDT- 2020/01/16 06:00
PHST- 2020/01/16 06:00 [pubmed]
PHST- 2020/05/07 06:00 [medline]
PHST- 2020/01/16 06:00 [entrez]
AID - 10.2214/AJR.19.22051 [doi]
PST - ppublish
SO  - AJR Am J Roentgenol. 2020 Mar;214(3):636-640. doi: 10.2214/AJR.19.22051. Epub 
      2020 Jan 15.