IMAGING OF CEREBRAL METASTASES

MR imaging with intravenous gadolinium has greatly enhanced our abilit y to detect and delineate intracranial metastases as well as to differ entiate them from other disease processes. Techniques such as magnetiz ation transfer and triple dose gadolinium imaging have further improve d lesion detection. Consideration of these radiologic techniques, incl uding the issues and controversies of screening and cost effectiveness , suggests a reasonable approach to imaging patients with possible int racranial metastases. Newer modalities such as echo planar imaging, sp ectroscopy PET, and SPECT, may in the future, prove to be very useful in the evaluation of patients with intracranial metastases. Proper ima ging is also critical to appropriate diagnosis and management of menin geal metastases, calvarial metastases, and paraneoplastic disease.