Value of screening and follow‐up brain MRI scans in patients with metastatic melanoma

Abstract Background Novel treatments make long‐term survival possible for subsets of patients with melanoma brain metastases. Brain magnetic resonance imaging (MRI) may aid in early detection of brain metastases and inform treatment decisions. This study aimed to determine the impact of screening MR...

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Main Authors: Annemarie C. Eggen, Thijs T. Wind, Ingeborg Bosma, Miranda C. A. Kramer, Peter Jan vanLaar, Hiska L. van derWeide, Geke A. P. Hospers, Mathilde Jalving
Format: Article
Language:English
Published: Wiley 2021-12-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.4342
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author Annemarie C. Eggen
Thijs T. Wind
Ingeborg Bosma
Miranda C. A. Kramer
Peter Jan vanLaar
Hiska L. van derWeide
Geke A. P. Hospers
Mathilde Jalving
author_facet Annemarie C. Eggen
Thijs T. Wind
Ingeborg Bosma
Miranda C. A. Kramer
Peter Jan vanLaar
Hiska L. van derWeide
Geke A. P. Hospers
Mathilde Jalving
author_sort Annemarie C. Eggen
collection DOAJ
description Abstract Background Novel treatments make long‐term survival possible for subsets of patients with melanoma brain metastases. Brain magnetic resonance imaging (MRI) may aid in early detection of brain metastases and inform treatment decisions. This study aimed to determine the impact of screening MRI scans in patients with metastatic melanoma and follow‐up MRI scans in patients with melanoma brain metastases. Methods This retrospective cohort study included patients diagnosed with metastatic melanoma or melanoma brain metastases between June 2015 and January 2018. The impact of screening MRI scans was evaluated in the first 2 years after metastatic melanoma diagnosis. The impact of follow‐up MRI scans was examined in the first year after brain metastases diagnosis. The number of MRI scans, scan indications, scan outcomes, and changes in treatment strategy were analyzed. Results In total, 116 patients had no brain metastases at the time of the metastatic melanoma diagnosis. Twenty‐eight of these patients (24%) were subsequently diagnosed with brain metastases. Screening MRI scans detected the brain metastases in 11/28 patients (39%), of which 8 were asymptomatic at diagnosis. In the 96 patients with melanoma brain metastases, treatment strategy changed after 75/168 follow‐up MRI scans (45%). In patients treated with immune checkpoint inhibitors, the number of treatment changes after follow‐up MRI scans was lower when patients had been treated longer. Conclusion(s) Screening MRI scans aid in early detection of melanoma brain metastases, and follow‐up MRI scans inform treatment strategy. In patients with brain metastases responding to immune checkpoint inhibitors, treatment changes were less frequently observed after follow‐up MRI scans. These results can inform the development of brain imaging protocols for patients with immune checkpoint inhibitor sensitive tumors.
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spelling doaj.art-bef6a4300a814097a36797f4f96af2082022-12-21T21:33:02ZengWileyCancer Medicine2045-76342021-12-0110238395840410.1002/cam4.4342Value of screening and follow‐up brain MRI scans in patients with metastatic melanomaAnnemarie C. Eggen0Thijs T. Wind1Ingeborg Bosma2Miranda C. A. Kramer3Peter Jan vanLaar4Hiska L. van derWeide5Geke A. P. Hospers6Mathilde Jalving7Department of Medical Oncology University of GroningenUniversity Medical Center Groningen Groningen The NetherlandsDepartment of Medical Oncology University of GroningenUniversity Medical Center Groningen Groningen The NetherlandsDepartment of Neurology University of GroningenUniversity Medical Center Groningen Groningen The NetherlandsDepartment of Radiation Oncology University of GroningenUniversity Medical Center Groningen Groningen The NetherlandsDepartment of Radiology Ziekenhuisgroep Twente, Almelo, and Hengelo Almelo The NetherlandsDepartment of Radiation Oncology University of GroningenUniversity Medical Center Groningen Groningen The NetherlandsDepartment of Medical Oncology University of GroningenUniversity Medical Center Groningen Groningen The NetherlandsDepartment of Medical Oncology University of GroningenUniversity Medical Center Groningen Groningen The NetherlandsAbstract Background Novel treatments make long‐term survival possible for subsets of patients with melanoma brain metastases. Brain magnetic resonance imaging (MRI) may aid in early detection of brain metastases and inform treatment decisions. This study aimed to determine the impact of screening MRI scans in patients with metastatic melanoma and follow‐up MRI scans in patients with melanoma brain metastases. Methods This retrospective cohort study included patients diagnosed with metastatic melanoma or melanoma brain metastases between June 2015 and January 2018. The impact of screening MRI scans was evaluated in the first 2 years after metastatic melanoma diagnosis. The impact of follow‐up MRI scans was examined in the first year after brain metastases diagnosis. The number of MRI scans, scan indications, scan outcomes, and changes in treatment strategy were analyzed. Results In total, 116 patients had no brain metastases at the time of the metastatic melanoma diagnosis. Twenty‐eight of these patients (24%) were subsequently diagnosed with brain metastases. Screening MRI scans detected the brain metastases in 11/28 patients (39%), of which 8 were asymptomatic at diagnosis. In the 96 patients with melanoma brain metastases, treatment strategy changed after 75/168 follow‐up MRI scans (45%). In patients treated with immune checkpoint inhibitors, the number of treatment changes after follow‐up MRI scans was lower when patients had been treated longer. Conclusion(s) Screening MRI scans aid in early detection of melanoma brain metastases, and follow‐up MRI scans inform treatment strategy. In patients with brain metastases responding to immune checkpoint inhibitors, treatment changes were less frequently observed after follow‐up MRI scans. These results can inform the development of brain imaging protocols for patients with immune checkpoint inhibitor sensitive tumors.https://doi.org/10.1002/cam4.4342brain metastasesearly diagnosismelanomaneuroimagingneuro‐oncology
spellingShingle Annemarie C. Eggen
Thijs T. Wind
Ingeborg Bosma
Miranda C. A. Kramer
Peter Jan vanLaar
Hiska L. van derWeide
Geke A. P. Hospers
Mathilde Jalving
Value of screening and follow‐up brain MRI scans in patients with metastatic melanoma
Cancer Medicine
brain metastases
early diagnosis
melanoma
neuroimaging
neuro‐oncology
title Value of screening and follow‐up brain MRI scans in patients with metastatic melanoma
title_full Value of screening and follow‐up brain MRI scans in patients with metastatic melanoma
title_fullStr Value of screening and follow‐up brain MRI scans in patients with metastatic melanoma
title_full_unstemmed Value of screening and follow‐up brain MRI scans in patients with metastatic melanoma
title_short Value of screening and follow‐up brain MRI scans in patients with metastatic melanoma
title_sort value of screening and follow up brain mri scans in patients with metastatic melanoma
topic brain metastases
early diagnosis
melanoma
neuroimaging
neuro‐oncology
url https://doi.org/10.1002/cam4.4342
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