Brain imaging in lung cancer patients without symptoms of brain metastases: a national survey of current practice in England

•Ascertain current practice in brain imaging for staging asymptomatic lung cancer patients.•Survey questionnaire sent to all the lung cancer lead clinicians in England.•Wide variation in practice with regard to brain imaging in this patient group.•No brain imaging at all in approximately half of centres and a spectrum of imaging in the other half•The 2011 NICE guidelines have led to some change in practice but not to national uniformity.

AimTo determine current practice regarding brain imaging for newly diagnosed lung cancer patients without symptoms of brain metastases.Materials and methodsA survey questionnaire was sent by e-mail to all the lung cancer lead clinicians in England currently on the National Cancer Intelligence Network database. The survey asked whether brain imaging was used in new lung cancer patients without symptoms or signs to suggest brain metastases; and if so, which patient subgroups were imaged according to cell type, stage of disease, and intention to treat, and which techniques were used to image these patients. Responses were received between February and May 2014.ResultsFifty-nine of 154 centres replied to the survey (38%). Thirty of the 59 centres (51%) did not image the brain in these patients. Twenty-nine of the 59 (49%) centres imaged the brain in at least certain subgroups. Of those centres that did image the brain 21 (72%) used CT as the first-line imaging technique and six (20%) used MRI. Twenty-five of 59 (42%) centres stated that the 2011 NICE guidelines had led to a change in their practice.ConclusionThere is wide variation in practice regarding brain imaging in this patient group in England, with no brain imaging at all in approximately half of centres and a spectrum of imaging in the other half. When the brain is imaged, CT is the technique most commonly used. The 2011 NICE guidelines have led to some change in practice but not to national uniformity.