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.
脑转移瘤是最常见的中枢神经系统肿瘤，其发病率不断上升，部分原因在于原发性癌症总体发病率增加、神经影像学检查手段进步提高了检出率、全身性治疗方案改善以及患者生存期延长。目的：识别发生中枢神经系统转移风险较高的癌症患者，并评估相关预后因素。方法：依据各癌症学会指南，对影像学转诊标准、疗效评估标准、定期影像学复查方案、优选检查模式，以及临床表现、血清学指标与影像学发现的关联性进行系统性综述。结果：根据各癌症学会及影像学项目指南，本文讨论了靶病灶与非靶病灶脑转移瘤的定量疗效评估方法，以及依据原发肿瘤组织学诊断和治疗状态制定的定期影像学复查方案。结论：临床管理中需综合考虑原发肿瘤的预测因素及脑转移瘤的独立变量（如病灶大小、数量及治疗反应）。中枢神经系统转移部位、症状性病变及随访影像学表现构成了疾病预后评估的基本框架，同时需充分考虑当前所有可用的新型先进治疗手段（包括手术、放疗和免疫治疗），这些治疗手段能显著改善患者预后。
肿瘤(癌症)患者之家