Advances in the Radiological Assessment of Melanoma Metastases in the Central Nervous System: Integrative Literature Review

Abstract

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.