Imaging Recommendations for Diagnosis, Staging, and Management of Central Nervous System Neoplasms in Adults: CNS Metastases

Sep 21, 2026

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Brain metastases (BMs) are the most common central nervous system neoplasms, with rising incidence linked to more primary cancers, improved neuroimaging detection, better systemic therapies, and longer survival. The article aims to identify cancer patients at higher risk of CNS metastases and assess prognostic factors. It reviews imaging referral guidance, response criteria, interval assessment, modality selection, and evidence from clinical, serological, and imaging findings across cancer societies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages19

Reading Time48 min

AccessFree to download

Introduction

Risk Factors, Epidemiology

Clinical Presentation

cancers Review Imaging Recommendations for Diagnosis, Staging, and Management of Central Nervous System Neoplasms in Adults: CNS Metastases Kajari Bhattacharya 1, Abhishek Mahajan 2,3, * and Soujanya Mynalli 1 Citation: Bhattacharya, K.; Mahajan, A.; Mynalli, S. Imaging Recommendations for Diagnosis, Staging, and Management of Central Nervous System Neoplasms in Adults: CNS Metastases. Cancers 2024, 16, 2667. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers16152667 Academic Editors: Alberto Feletti and Takashi Sugawara Received: 27 May 2024 Revised: 7 July 2024 Accepted: 12 July 2024 Published: 26 July 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, India; [kajaribhattacharya7@gmail.com](kajaribhattacharya7@gmail.com) (K.B.); [soju.mynalli@gmail.com](soju.mynalli@gmail.com) (S.M.) 2 Department of Imaging, The Clatterbridge Cancer Centre NHS Foundation Trust, 65 Pembroke Place, Liverpool L7 8YA, UK 3 Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 3BX, UK * Correspondence: [abhishek.mahajan@nhs.net](abhishek.mahajan@nhs.net) Simple Summary: Brain tumors that spread from cancer elsewhere in the body (brain metastases) are becoming more common due to better cancer detection. While historically the outlook for patients with brain metastases was poor, new minimally invasive surgeries and targeted therapies are improving prognoses. Imaging features also depict responses to treatment and help identify the cause of patients’ symptoms worsening due to disease or therapy. The development of new MRI techniques, the use of artificial intelligence, and advanced therapeutic delivery systems are creating even more powerful tools that are directly contributing to improving patient care and better survival for patients with brain metastases. This article explores the screening and diagnostic and prognostic roles of various imaging modalities, and recommends standard guidelines in the management of cancer patients to improve the overall survival rate. Abstract: Brain metastases (BMs) are the most common central nervous system (CNS) neoplasms, with an increasing incidence that is due in part to an overall increase in primary cancers, improved neuroimaging modalities leading to increased detection, better systemic therapies, and longer patient survival. Objective: To identify cancer patients at a higher risk of developing CNS metastases and to evaluate associated prognostic factors. Methods: Review of imaging referral guidelines, response criteria, interval imaging assessment, modality of choice, as well as the association of clinical, serological, and imaging findings as per various cancer societies. Results: Quantitative response assessment of target and non-target brain metastases as well as an interval imaging protocol set up based on primary histological diagnosis and therapy status are discussed as per various cancer societies and imaging programs. Conclusion: Predictive factors in the primary tumor as well as independent variables of brain metastases like size, number, and response to therapy are necessary in management. The location of CNS metastases, symptomatic disease, as well as follow up imaging findings form a skeletal plan to prognosticate the disease, keeping in mind all the available new advanced therapy options of surgery, radiation, and immunotherapy that improve patient outcome significantly. Keywords: CNS metastases; MR imaging; adult brain metastasis; artificial intelligence 1. Introduction Brain metastases (BMs) are the most common c

FAQs

What are brain metastases (BMs) and why is their incidence increasing?

BMs are common CNS neoplasms whose incidence is rising due to increasing primary cancers, better neuroimaging detection, improved systemic therapies, and longer patient survival.

What is the article’s objective?

It identifies cancer patients at higher risk of developing CNS metastases and evaluates associated prognostic factors.

How does the article approach imaging recommendations?

It reviews imaging referral guidelines, response criteria, interval imaging assessment, modality of choice, and the relationships between clinical, serological, and imaging findings reported by cancer societies.

Sep 21, 2026

Upload by Oliver