Impact of routine brain imaging in the initial management of lung cancer

Introduction. - Brain metastases are a common complication of bronchial carcinoma (BC). There is no consensus as to the need to undertake a systematic search for these lesions during the initial assessment. The aim of this study was to evaluate the contribution of brain imagingin the initial evaluation of patients with CB. Methods. - We undertook a retrospective analysis of patients treated in the Thoracic Oncology Clinic at the Institute Jules-Bordet between 01/09/2008 and 31/08/2013, who were treatment naive and were having a full diagnostic work-up including brain imaging. Results. - Four hundred and sixty-three patients consecutively diagnosed with BC were included. Brain magnetic resonance imaging and/or CT-scan showed brain metastases in 101 patients(21.8%), of whom 67 had no symptoms suggestive of brain metastatic disease. The addition of a brain imaging into the work-up procedure resulted in a stage migration for 30 patients (6.5%), mainly otherwise staged IIIA (n = 10) or IIIB (n = 14) without brain imaging. Conclusion. - The addition of brain imaging in the initial assessment of bronchial carcinomaallows the identification of brain metastases in one case among 5, of which 2/3 are asymptomatic. This leads to a change in staging, primarily for disease otherwise considered to be stage III. (c) 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.