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AJNR - American Journal of Neuroradiology

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Improved Detection of Metastatic Melanoma by T2*-Weighted Imaging

P. Gaviani^a, M.E. Mullins^b,e, T.A. Braga^a, E.T. Hedley-Whyte^c,e, E.F. Halpern^d,e, P.S. Schaefer^b,e and J.W. Henson^a,b,e

^a Stephen E. and Catherine Pappas Center for Neuro-Oncology, Harvard Medical School, Boston, Mass
^b Division of Neuroradiology, Harvard Medical School, Boston, Mass
^c Division of Neuropathology, Harvard Medical School, Boston, Mass
^d Department of Radiology, Harvard Medical School, Boston, Mass
^e Massachusetts General Hospital, Harvard Medical School, Boston, Mass

View larger version (78K): [in a new window]   Fig 1. Melanoma brain metastases were detected principally on T2*-weighted sequences in 7% of 120 lesions. T1 isointense, nonenhancing lesions are seen in the right cerebellar hemisphere lesion (top row) and left frontal lobe (bottom row). A subtle abnormality can be seen on the FLAIR image (G), but the lesion is markedly more conspicuous on T2*-weighted image (H). T1-weighted sequences before (A, E) and after (B, F) administration of gadolinium, FLAIR sequences (C, G), and T2*-weighted sequences (D, H) are shown.

View larger version (144K): [in a new window]   Fig 2. Combined susceptibility effect and T1-weighted hyperintensity were seen in only one quarter of lesions, but this combination was 16 times more likely with melanoma than with lung cancer metastases. Intrinsic T1-weighted hyperintensity (A), minimal enhancement (B), minimal surrounding edema on a FLAIR image (C), and susceptibility effect (D) are shown in metastatic melanoma in the right frontal lobe.