Abstract 1353P
Background
The aim of our study was to test the hypothesis that the spatial distribution of brain metastases (BMs) from small cell lung cancer (SCLC) is different from that of non-small cell lung cancer (NSCLC).
Methods
T1 enhanced MR images from SCLC and NSCLC were retrospectively reviewed from three medical institutions in China. All images were registered to the standard brain template provided by the Montreal Neurological Institute (MNI) 152 database, followed by transform the location of all BMs to the space of standard brain. The MNI structural atlas and Anatomical Automatic Labeling (AAL) atlas were then used to identify the anatomical brain regions, and compare the observed rate and expected rate of BMs using 2-tailed proportional hypothesis testing. The locations and sizes of brain lesions were analyzed after image standardization.
Results
A total of 728 eligible patients with 2997 lesions were screened. SCLC is more likely to occur in deep white matter, brainstem and cerebellum (P<0.000), while NSCLC prefers frontal lobe (P < 0.001) and occipital lobe (P < 0.05). In both SCLC and NSCLC, the cerebellum is a high-risk area, while the temporal lobe is a low-risk area. The difference is that the frontal lobe is at high risk in NSCLC and low risk in SCLC. Based on a more detailed analysis of the ALL Atlas, 11 risk areas were identified for SCLC, while 23 for NSCLC. Parahippocampal gyrus, cingulate gyrus, gyrus rectus are low-risk regions in NSCLS, but not in SCLC. The cumulative risk of several critical brain structures was significantly higher in the SCLC group than in the NSCLC group (6.23% vs. 3.77%, respectively). Heat map showed that SCLC distribution was more diffuse, while NSCLC distribution was more tendential.
Conclusions
The same spatial distribution characteristics may be based on the results of vascular system, while the differences may be based on the results of different pathological genetics. To identify and quantitatively analyze high-risk and low-risk areas of brain metastasis in order to provide data support for radiotherapy strategy selection.
Clinical trial identification
Editorial acknowledgement
Not applicable.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.