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Brain metastases from lung cancer — SCE Respiratory MCQ

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HardLung CancerBrain metastases from lung cancerSCE Respiratory

A fit patient with clinical stage IIIA non-small-cell lung cancer has no neurological symptoms and is being considered for curative multimodality treatment. Which intracranial investigation is required?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Contrast-enhanced brain MRI before the treatment plan is finalised

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · E = shown as D · B = shown as E

C is correct. NICE recommends contrast-enhanced brain MRI for clinical stage III NSCLC being treated with curative intent because occult intracranial disease changes treatment intent. PET-CT is insensitive for small brain metastases, non-contrast CT is inadequate, and neither CSF cytology nor somatostatin-receptor imaging is a routine staging substitute.

Reference: https://www.nice.org.uk/guidance/ng122/chapter/Diagnosis-and-staging