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Silent Brain Metastasis in the Initial Staging of Lung Cancer: Evaluation by Computed Tomography and Magnetic Resonance Imaging
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Agustín Sojo González, José Zamorano Quirantes, Carlos Disdier Vicente, María Cristina Pérez Calvo" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Julio Sánchez" "apellidos" => "de Cos Escuín" "email" => array:1 [ 0 => "jsd01cc@saludalia.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Diego Masjoans" "apellidos" => "Menna" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "M. Agustín Sojo" "apellidos" => "González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "José Zamorano" "apellidos" => "Quirantes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 4 => array:3 [ "nombre" => "Carlos Disdier" "apellidos" => "Vicente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 5 => array:3 [ "nombre" => "María Cristina Pérez" "apellidos" => "Calvo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Sección de Neumología, Hospital San Pedro de Alcántara, Cáceres, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Unidad de Resonancia Magnética, Clínica San Francisco, Cáceres, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Unidad de Investigación Clínica, Hospital San Pedro de Alcántara, Cáceres, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Servicio de Radiología, Hospital San Pedro de Alcántara, Cáceres, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Sánchez de Cos Escuín. Isla de Hierro, 2, 3.°C. 10001 Cáceres. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-02-22" "fechaAceptado" => "2006-11-11" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154933" "palabras" => array:4 [ 0 => "Lung cancer" 1 => "Silent brain metastasis" 2 => "Computed tomography" 3 => "Magnetic resonance imaging" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154932" "palabras" => array:4 [ 0 => "Cáncer de pulmón" 1 => "Metástasis cerebrales silentes" 2 => "Tomografía computarizada" 3 => "Resonancia magnética" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">OBJECTIVE</span><p class="elsevierStyleSimplePara elsevierViewall">Brain metastases are common in patients with lung cancer and influence both prognosis and treatment decisions. The aim of this study was to evaluate the incidence of silent brain metastasis during the initial staging of lung cancer using cranial computed tomography (CT) and magnetic resonance imaging (MRI).</p> <span class="elsevierStyleSectionTitle">PATIENTS AND METHODS</span><p class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective analysis of lung cancer patients with no neurologic signs or symptoms who were evaluated by cranial CT, MRI, or both at the time of diagnosis. Results were checked using data obtained during systematic monitoring of progression. The incidence of brain metastasis was analyzed by sex, age, histology, and TNM stage.</p> <span class="elsevierStyleSectionTitle">RESULTS</span><p class="elsevierStyleSimplePara elsevierViewall">Silent brain metastasis was detected in 8.3% of the 169 patients with lung cancer. The detection rate was 7.9% in the cranial CT group and 11.3% in the cranial MRI group. The percentage of false positives and false negatives was 0% and 1.9%, respectively. Cranial MRI performed better than CT in detecting multiple brain metastases (72.8% vs 50%) and metastases smaller than 1 cm (36.3% vs 16.7%). The incidence of brain metastasis was lower in patients aged over 70 years and higher in patients with adenocarcinoma (20% compared to 5.3% to 5.9% for other histologic subtypes, <span class="elsevierStyleItalic">P</span>=.01). No association was found with TNM stage.</p> <span class="elsevierStyleSectionTitle">CONCLUSIONS</span><p class="elsevierStyleSimplePara elsevierViewall">The incidence of silent brain metastasis is high in patients under 70 years of age, particularly in patients with adenocarcinomas, even in initial stages. This should be taken into consideration when planning staging procedures. Cranial MRI seems to be more accurate than cranial CT for detecting multiple metastases and small metastases.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">OBJETIVO</span><p class="elsevierStyleSimplePara elsevierViewall">Las metástasis cerebrales (MC) son frecuentes en el cáncer de pulmón (CP) y tienen influencia pronóstica y terapéutica. El objetivo del trabajo ha sido evaluar la incidencia de MC silentes en la estadificación inicial del CP mediante tomografía axial computarizada y resonancia magnética craneales (TACC y RMC).</p> <span class="elsevierStyleSectionTitle">PACIENTES Y MÉTODOS</span><p class="elsevierStyleSimplePara elsevierViewall">Análisis retrospectivo de los pacientes con CP que tenían un estudio craneal mediante TACC y/o RMC en ausencia de síntomas/signos neurológicos en el momento del diagnóstico. Para verificar los resultados se usó como criterio la evolución mediante un seguimiento frecuente. Se comparó la incidencia de MC según sexo, edad, histología y estadio TNM.</p> <span class="elsevierStyleSectionTitle">RESULTADOS</span><p class="elsevierStyleSimplePara elsevierViewall">Se detectaron MC silentes en el 8,3% de 169 pacientes con CP: un 7,9% en el grupo de TACC y un 11,3%, en el de RMC. La tasa de resultados falsos positivos fue del 0% y la de falsos negativos, del 1,9%. La RMC detectó más MC múltiples (un 72,8 frente a un 50%) y menores de 1 cm (un 36,3 frente a un 16,7%) que la TACC. La incidencia de MC fue menor en mayores de 70 años y superior en adenocarcinomas (un 20 frente a un 5,3–5,9%; p = 0,01). No hubo relación con el grado de extensión.</p> <span class="elsevierStyleSectionTitle">CONCLUSIONES</span><p class="elsevierStyleSimplePara elsevierViewall">En pacientes menores de 70 años y espe cialmente en adenocarcinomas, la incidencia de MC silentes es elevada, incluso en estadios iniciales, lo que debería considerarse al planificar las pruebas de estadificación. La RMC parece más exacta para detectar MC múltiples y de pequeño tamaño.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:22 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of brain metastasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "RA Patchell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "2002 Educational Book. 38th Annual Meeting of American Society of Clinical Oncology" "paginaInicial" => "383" "paginaFinal" => "391" "serieFecha" => "2002" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "LJ Schouten" 1 => "J Rutten" 2 => "HAM Huveneers" 3 => "A Twijnstra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Cancer" "fecha" => "2002" "volumen" => "94" "paginaInicial" => "2698" "paginaFinal" => "2705" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12173339" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1474442211700175" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The clinical evaluation for detecting metastatic lung cancer. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 5 | 8 |
| 2024 October | 34 | 14 | 48 |
| 2024 September | 41 | 15 | 56 |
| 2024 August | 48 | 37 | 85 |
| 2024 July | 27 | 30 | 57 |
| 2024 June | 28 | 22 | 50 |
| 2024 May | 36 | 34 | 70 |
| 2024 April | 23 | 27 | 50 |
| 2024 March | 20 | 14 | 34 |
| 2024 February | 19 | 17 | 36 |
| 2023 March | 6 | 2 | 8 |
| 2023 February | 18 | 27 | 45 |
| 2023 January | 21 | 30 | 51 |
| 2022 December | 28 | 24 | 52 |
| 2022 November | 23 | 34 | 57 |
| 2022 October | 22 | 29 | 51 |
| 2022 September | 17 | 24 | 41 |
| 2022 August | 19 | 44 | 63 |
| 2022 July | 28 | 42 | 70 |
| 2022 June | 24 | 27 | 51 |
| 2022 May | 29 | 32 | 61 |
| 2022 April | 29 | 25 | 54 |
| 2022 March | 45 | 37 | 82 |
| 2022 February | 29 | 21 | 50 |
| 2022 January | 37 | 41 | 78 |
| 2021 December | 24 | 45 | 69 |
| 2021 November | 33 | 46 | 79 |
| 2021 October | 64 | 46 | 110 |
| 2021 September | 30 | 63 | 93 |
| 2021 August | 20 | 28 | 48 |
| 2021 July | 16 | 36 | 52 |
| 2021 June | 20 | 25 | 45 |
| 2021 May | 15 | 21 | 36 |
| 2021 April | 30 | 49 | 79 |
| 2021 March | 19 | 15 | 34 |
| 2021 February | 19 | 21 | 40 |
| 2021 January | 14 | 15 | 29 |
| 2020 December | 12 | 17 | 29 |
| 2020 November | 6 | 8 | 14 |
| 2020 October | 13 | 11 | 24 |
| 2020 September | 13 | 7 | 20 |
| 2020 August | 9 | 11 | 20 |
| 2020 July | 16 | 14 | 30 |
| 2020 June | 14 | 7 | 21 |
| 2020 May | 16 | 9 | 25 |
| 2020 April | 17 | 15 | 32 |
| 2020 March | 11 | 10 | 21 |
| 2020 February | 10 | 14 | 24 |
| 2020 January | 13 | 17 | 30 |
| 2019 December | 12 | 16 | 28 |
| 2019 November | 4 | 5 | 9 |
| 2019 October | 4 | 6 | 10 |
| 2019 September | 5 | 13 | 18 |
| 2019 August | 5 | 4 | 9 |
| 2019 July | 15 | 21 | 36 |
| 2019 June | 5 | 9 | 14 |
| 2019 May | 6 | 14 | 20 |
| 2019 April | 7 | 49 | 56 |
| 2019 March | 9 | 20 | 29 |
| 2019 February | 7 | 7 | 14 |
| 2019 January | 6 | 9 | 15 |
| 2018 December | 11 | 12 | 23 |
| 2018 November | 15 | 12 | 27 |
| 2018 October | 19 | 18 | 37 |
| 2018 September | 13 | 16 | 29 |
| 2018 May | 7 | 0 | 7 |
| 2018 April | 7 | 5 | 12 |
| 2018 March | 6 | 3 | 9 |
| 2018 February | 4 | 7 | 11 |
| 2018 January | 6 | 7 | 13 |
| 2017 December | 5 | 8 | 13 |
| 2017 November | 6 | 7 | 13 |
| 2017 October | 5 | 12 | 17 |
| 2017 September | 2 | 6 | 8 |
| 2017 August | 5 | 10 | 15 |
| 2017 July | 1 | 4 | 5 |
| 2017 June | 11 | 14 | 25 |
| 2017 May | 2 | 5 | 7 |
| 2017 April | 2 | 4 | 6 |
| 2017 March | 1 | 28 | 29 |
| 2017 February | 4 | 5 | 9 |
| 2017 January | 3 | 6 | 9 |
| 2016 December | 3 | 2 | 5 |
| 2016 November | 11 | 4 | 15 |
| 2016 October | 14 | 11 | 25 |
| 2016 September | 10 | 10 | 20 |
| 2016 August | 9 | 4 | 13 |
| 2016 July | 9 | 6 | 15 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 103 | 10 | 113 |
| 2015 September | 128 | 10 | 138 |
| 2015 August | 112 | 7 | 119 |
| 2015 July | 117 | 15 | 132 |
| 2015 June | 100 | 8 | 108 |
| 2015 May | 103 | 9 | 112 |
| 2015 April | 83 | 12 | 95 |
| 2015 March | 103 | 7 | 110 |
| 2015 February | 102 | 7 | 109 |
| 2015 January | 108 | 12 | 120 |
| 2014 December | 123 | 6 | 129 |
| 2014 November | 148 | 15 | 163 |
| 2014 October | 208 | 15 | 223 |
| 2014 September | 134 | 7 | 141 |
| 2014 August | 137 | 8 | 145 |
| 2014 July | 95 | 12 | 107 |
| 2014 June | 105 | 17 | 122 |
| 2014 May | 83 | 8 | 91 |
| 2014 April | 96 | 12 | 108 |
| 2014 March | 84 | 12 | 96 |
| 2014 February | 74 | 10 | 84 |
| 2014 January | 57 | 11 | 68 |
| 2013 December | 60 | 10 | 70 |
| 2013 November | 47 | 5 | 52 |
| 2013 October | 61 | 13 | 74 |
| 2013 September | 54 | 12 | 66 |
| 2013 August | 50 | 11 | 61 |
| 2013 July | 71 | 13 | 84 |
| 2013 June | 47 | 4 | 51 |
| 2013 May | 48 | 2 | 50 |
| 2013 April | 32 | 10 | 42 |
| 2013 March | 8 | 1 | 9 |
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