Can nonenhancing white matter lesions in cancer patients be disregarded?
AD Elster and MY Chen Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157-1022. PURPOSE: To assess the risks and implications of assuming that white matter lesions in cancer patients that do not enhance with gadopentetate dimeglumine (Gd-DTPA) can be considered to be benign. METHODS: Gd-DTPA was administered prospectively to 131 consecutive patients with biopsy-proved extracranial malignancies referred for cranial MR imaging to exclude cerebral metastases over a 21/2-year period. From this initial group, 50 patients were identified who had focal nonenhancing lesions of the white matter on T2-weighted images, but no other findings to suggest metastatic disease. This cohort of 50 patients was then followed for at least 1 year to determine the risk and clinical implications of assuming these nonenhancing white matter lesions were benign. RESULTS: Thirty patients (60%) were alive and clinically free of cranial metastatic disease at least
