. Author manuscript; available in PMC: 2022 Oct 2.

Published in final edited form as: Int J Radiat Oncol Biol Phys. 2019 Oct 10;106(3):579–586. doi: 10.1016/j.ijrobp.2019.10.002

Table 1.

Proposed classification of intracranial progression after treatment for brain metastases

Intracranial disease	Supportive neuroimaging features^*

Classical leptomeningeal disease (cLMD)	Enhancement of cranial nerves Curvilinear enhancement within: Cerebellar folia Cerebral sulci Cerebral cisterns Diffuse “sugar coating” of the surface of the brain
Nodular leptomeningeal disease (nLMD)	Focal nodule(s) adherent to surfaces with CSF contact: Dural/pial surface Tentorium Ventricles Hypervascular dural tail
Distant intraparenchymal metastases	Focal lesion deep to the pial surface Hematogenous spread pattern
Local recurrence	Nodular enhancement within the resection cavity In-field recurrence within the 80% isodose line

Note: cLMD and nLMD can be further subjectively described as “localized” or “disseminated.”

This column summarizes the pattern of recurrence radiographic labeling guidelines provided to raters in the training modules.