Leptomeningeal metastases in the MRI era

• DOI: 10.1212/wnl.0b013e3181dc1a69
• Publication Date: 2010-05-03T20:35:52Z
• Authors: J.L. Clarke; H.R. Perez; L.M. Jacks; K.S. Panageas; L.M. DeAngelis
• Keywords: Hematopoietic growth factor

<b>Background:</b> Diagnosis of leptomeningeal metastasis (LM) has become increasingly frequent. The diagnostic gold standard been CSF cytology, but MRI is now used routinely for diagnosis. and prognosis LM not studied in the era. <b>Methods:</b> Patients with from 2002 through 2004 were identified a neurology database, as well by reviewing all abnormal cytologies pathology database. was made malignant cytology or imaging; suspicious cases treated also included. <b>Results:</b> A total 187 patients analyzed this retrospective review. Of these, 150 had solid 37 hematopoietic malignancies. Median age 56.4 years, median Karnofsky performance status (KPS) 70. most common types tumor breast (65 patients), lung (47), gastrointestinal (11), melanoma (9). tumors, 21 lymphoma 15 leukemia. Fifty-three percent diagnosed imaging, 23% 24% both. Treatment included radiation therapy 55%, intrathecal chemotherapy 29%, systemic 18%; 21% received supportive care alone. overall survival 2.4 (95% confidence interval 1.9–3.1) months. tumors 4.7 months 2.3 (<i>p</i> = 0.0006). In multivariate analysis, initial KPS type (solid vs hematopoietic) significant predictors survival. <b>Conclusions:</b> Despite enhanced diagnosis MRI, remains poor metastasis. Those continue to fare better than those tumors.