Choroid plexus asymmetry on routine MRI as an imaging signature of breast cancer brain metastasis

Background. Brain metastasis affects 15-30% of patients with breast cancer, yet brain-specific biology underlying central nervous system colonisation is poorly captured by available clinical measures. The choroid plexus, an MRI biomarker of neuroinflammation and a primary immune-cell gateway implicated in brain metastasis, has not been examined in this setting. Methods. In a real-world, cross-sectional study of 1,000 women with breast cancer (190 with brain metastasis), bilateral choroid plexus volumes on contrast-enhanced brain MRI were quantified using a deep-learning pipeline. Guided by the

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