We prospectively investigated 40 patients with small-cell carcinoma of
the lung (SCLC) for signs of brain metastasis by neurological examina
tion and MRI of the brain, to determine the significance of MRI for st
aging. MRI could not be completed in one patient, who was excluded fro
m the study. The MRI studies of the remaining patients showed no abnor
malities in 12, cerebral infarcts in 2 and brain metastases in 11 pati
ents, of whom 3 no relevant symptoms. Nonenhancing white matter lesion
s were found in 14 patients. In 3 of the 4 patients with an abnormal n
eurological examination at diagnosis, nonenhancing white matter lesion
s later developed into contrast enhancing lesions compatible with brai
n metastases; in 2, this occurred during the course of the chemotherap
y. MRI did not change the clinical staging in patients with asymptomat
ic brain metastases.