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The Clinical Limitations of Brain Scanning in Metastatic Disease

University of Kentucky Medical Center, Lexington, Kentucky

Correspondence: ¹ For reprints contact: William H. Brooks, Dept. of Neurosurgery, and Radiation Medicine, University of Kentucky Medical Center, Lexington, Ky. 40506.

ABSTRACT

Brain scans of forty-seven patients who underwent craniotomy for metastatic brain tumors from 1965 to 1972 were studied. Scans were performed with ^99mTc-pertechnetate. Seventy-six percent of the patients had positive brain scans with the best correlation existing in metastatic lesions from the lung and malignant melanoma. Brain scans of patients with metastatic adenocarcinoma of the colon were "negative, in spite of a surgically significant space-occupying lesion". The solitary lesions averaged 4-cm in diameter and were grossly totally removed. It can be concluded that a negative brain scan in a patient with cancer and symptoms suggesting neurological disease cannot definitely rule out cerebral metastases. This conclusion is particularly true in patients with colonic cancer.