Advances in the Radiological Assessment of Melanoma Metastases in the Central Nervous System: Integrative Literature Review
DOI:
https://doi.org/10.32635/2176-9745.RBC.2026v72n4.5685Keywords:
Melanoma, Neoplastic Metastasis, Central Nervous System, Diagnostic ImagingAbstract
Introduction: Melanoma metastases in the central nervous system (CNS) represent a significant clinical challenge due to their high aggressiveness and prognostic impact. In this context, advances in imaging techniques have expanded the ability to detect, characterize, and differentiate these metastases. Objective: To analyze advances in the radiological assessment of melanoma metastases in the CNS. Method: An integrative literature review was conducted using the PubMed, SciELO, and Virtual Health Library databases, including articles published between 2015 and 2025, following the PICO strategy. Results: Eleven studies highlighted relevant advances in imaging techniques, particularly magnetic resonance imaging (MRI). Contrast-enhanced T1-weighted MRI was identified as the most sensitive technique for early detection of brain metastases, outperforming sequences such as T2-FLAIR and susceptibility-weighted imaging (SWI). Although SWI is useful in specific contexts, it has limitations in the diagnosis of melanotic metastases. Advanced techniques such as perfusion and diffusion provided complementary benefits in differentiating types of metastases but showed limitations in distinguishing their primary origins. The presence of leptomeningeal micrometastases and multiple lesions was associated with poorer prognosis, emphasizing the importance of a more detailed prognostic assessment. Conclusion: The combination of advanced imaging techniques is essential for a comprehensive assessment, providing valuable information for clinical and therapeutic management while emphasizing the need for multidimensional approaches to improve the diagnosis and treatment of these metastases.
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Instituto Nacional de Câncer. Estimativa 2026: incidência de câncer no Brasil [Internet]. 2. ed. rev. atual. Rio de Janeiro: INCA; 2026 [acesso 2026 set 15]. Disponível em: https://ninho.inca.gov.br/jspui/handle/123456789/18062
Berk BA, Hering K, Kortmann RD, et al. Vascular white matter lesions negatively correlate with brain metastases in malignant melanoma-results from a retrospective comparative analysis. Clin Neurol Neurosurg. 2019;180:117-21. doi: https://doi.org/10.1016/j.clineuro.2019.03.016 DOI: https://doi.org/10.1016/j.clineuro.2019.03.016
Nguyen A, Nguyen A, Dada OT, et al. Leptomeningeal metastasis: a review of the pathophysiology, diagnostic methodology, and therapeutic landscape. Curr Oncol. 2023;30(6):5906-31. doi: https://doi.org/10.3390/curroncol30060442 DOI: https://doi.org/10.3390/curroncol30060442
Steininger J, Gellrich FF, Engellandt K, et al. Leptomeningeal metastases in melanoma patients: an update on and future perspectives for diagnosis and treatment. Int J Mol Sci. 2023;24(14):11443. doi: https://doi.org/10.3390/ijms241411443 DOI: https://doi.org/10.3390/ijms241411443
Karz A, Dimitrova M, Kleffman K, et al. Melanoma central nervous system metastases: an update to approaches, challenges, and opportunities. Pigment Cell Melanoma Res. 2022;35(6):554-72. doi: https://doi.org/10.1111/pcmr.13059 DOI: https://doi.org/10.1111/pcmr.13059
Serra E, Abarzua-Araya Á, Arance A, et al. Predictive and prognostic factors in melanoma central nervous system metastases-a cohort study. Cancers. 2024;16(12):2272. doi: https://doi.org/10.3390/cancers16122272 DOI: https://doi.org/10.3390/cancers16122272
Vega-Moreno DA, Kuramitsu S, Kaoru E, et al. Demographics aspects of brain and spine metastatic melanoma. Retrospective analysis in a single third-level center. World Neurosurg X. 2024;22:100306. doi: https://doi.org/10.1016/j.wnsx.2024.100306 DOI: https://doi.org/10.1016/j.wnsx.2024.100306
Tawbi H, To TM, Bartley K, et al. Treatment patterns and clinical outcomes for patients with melanoma and central nervous system metastases: a real-world study. Cancer Med. 2022;11(1):139-50. doi: https://doi.org/10.1002/cam4.4438 DOI: https://doi.org/10.1002/cam4.4438
Askaner K, Rydelius A, Engelholm S, et al. Differentiation between glioblastomas and brain metastases and regarding their primary site of malignancy using dynamic susceptibility contrast MRI at 3T. J Neuroradiol. 2019;46(6):367-72. doi: https://doi.org/10.1016/j.neurad.2018.09.006 DOI: https://doi.org/10.1016/j.neurad.2018.09.006
Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: https://doi.org/10.1136/bmj.n71 DOI: https://doi.org/10.1136/bmj.n71
Reiter FP, Giessen-Jung C, Dorostkar MM, et al. Miliary pattern of brain metastases - a case report of a hyperacute onset in a patient with malignant melanoma documented by magnetic resonance imaging. Radiat Oncol. 2015;10:148. doi: https://doi.org/10.1186/s13014-015-0459-8 DOI: https://doi.org/10.1186/s13014-015-0459-8
Jung BC, Arevalo-Perez J, Lyo JK, et al. Comparison of glioblastomas and brain metastases using dynamic contrast-enhanced perfusion MRI. J Neuroimaging. 2016;26(2):240-6. doi: https://doi.org/10.1111/jon.12281 DOI: https://doi.org/10.1111/jon.12281
Sarbu N, Pujol T, Oleaga L. Hyperintense perilesional edema in the brain on T1-weighted images: cavernous malformation or metastatic melanoma? Three case reports and literature review. Neuroradiol J. 2016;29(1):52-6. doi: https://doi.org/10.1177/1971400915626430 DOI: https://doi.org/10.1177/1971400915626430
Nabavizadeh SA, Pechersky D, Schmitt JE, et al. Perilesional hyperintensity on T1-weighted images in intra-axial brain masses other than cavernous malformations. J Neuroimaging. 2017;27(5):531-8. doi: https://doi.org/10.1111/jon.12424 DOI: https://doi.org/10.1111/jon.12424
Deike-Hofmann K, Thünemann D, Breckwoldt MO, et al. Sensitivity of different MRI sequences in the early detection of melanoma brain metastases. PLoS One. 2018;13(3):e0193946. doi: https://doi.org/10.1371/journal.pone.0193946 DOI: https://doi.org/10.1371/journal.pone.0193946
Schwarz D, Niederle T, Münch P, et al. Susceptibility-weighted imaging in malignant melanoma brain metastasis. J Magn Reson Imaging. 2019;50(4):1251-9. doi: https://doi.org/10.1002/jmri.26692 DOI: https://doi.org/10.1002/jmri.26692
Lasocki A, Khoo C, Lau PKH, et al. High-resolution MRI demonstrates that more than 90% of small intracranial melanoma metastases develop in close relationship to the leptomeninges. Neuro Oncol. 2020;22(3):423-32. doi: https://doi.org/10.1093/neuonc/noz171 DOI: https://doi.org/10.1093/neuonc/noz171
Ostojic J, Kozic D, Panjkovic M, et al. Peak Resembling N-acetylaspartate (NAA) on magnetic resonance spectroscopy of brain metastases. Medicina. 2024;60(4):662. doi: https://doi.org/10.3390/medicina60040662 DOI: https://doi.org/10.3390/medicina60040662
Ibrahim RM, Rahman SAA, Elnekeidy AEAM. Added value of delayed post-contrast FLAIR in diagnosis of metastatic brain lesions. Egypt J Radiol Nucl Med. 2022;53(205):1-12. doi: https://doi.org/10.1186/s43055-022-00844-7 DOI: https://doi.org/10.1186/s43055-022-00844-7
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