Clinically Silent Brain Metastases: Can Radionuclide Scintigraphy Detect Them?

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Abstract
The role of static and dynamic radionuclide brain imaging in the detection of occult brain metastases was evaluated by reviewing the brain images and case histories of 136 patients with neoplastic disease (mostly lung cancer) who, at the time of the scintigraphic study, lacked clinical evidence of brain metastases. Static studies were normal in 121, equivocal in 13, and abnormal in 2. One of the patients with an abnormal study had dural metastases; the other had skull metastases. None of the 13 equivocal scans was found to be indicative of metastasic disease. Cerebral flood flow studies were performed in 99 of the 136 patients and all were negative for evidence of metastatic disease. The results of this study do not support the use of brain scintigraphy for routine screening of asymptomatic cancer patients.

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