Revealing innumerable occult lesions with T1-weighted 3Dblack-blood-imaging in the detection of intracranial metastatic melanoma under BRAF therapy

In the setting of melanoma, brain metastases are very common and contribute to a large number of different neurological deficits as well as death. In recent years, the general prognosis for patients with intracranial metastatic melanoma has improved due to progress in imaging and therapeutic management. The addition of a contrastenhanced T1-weighted MSDE sequence, a so-called Black-Blood - sequence, to the initial and follow up-scans is an excellent method to display intracranial metastatic melanoma. With this case report we want to demonstrate the possible big discrepancy in the number of metastases displayed by the Black-Blood-sequence compared to contrast enhanced T1-weighted imaging in the setting of BRAF-mutated intracranial metastatic melanoma.