Primary intramedullary spinal-cord lymphoma (PISCL): a rare entity with a challenging diagnosis

2021 ◽  
Vol 14 (5) ◽  
pp. e242548
Author(s):  
Emanuel Santos Martins ◽  
Cristina Duque ◽  
Olinda Rebelo ◽  
Sónia Batista
Keyword(s):  
Spinal Cord ◽  
Positron Emission Tomography ◽  
Central Nervous System ◽  
Emission Tomography ◽  
Rare Entity ◽  
Histological Findings ◽  
Intramedullary Spinal Cord ◽  
Positron Emission ◽  
Pet Ct ◽  
The Impact

Primary intramedullary spinal-cord lymphoma (PISCL) is a rare cause of myelopathy and constitutes only 1% of central nervous system lymphomas. Delay to diagnosis is common due to its rarity, its similarity to other causes of myelopathy and the difficulties in obtaining pathological diagnosis. We report a case of PISCL and discuss the challenges faced on diagnosis, namely the impact of corticosteroids on histological findings, the usefulness of MRI, positron-emission tomography/CT (PET/CT) and repeated lumbar punctures.

Etiology of Solitary Extrapulmonary Positron Emission Tomography and Computed Tomography Findings in Patients With Lung Cancer

2005 ◽  
Vol 23 (28) ◽  
pp. 6846-6853 ◽  
Author(s):  
Didier Lardinois ◽  
Walter Weder ◽  
Marina Roudas ◽  
Gustav K. von Schulthess ◽  
Michaela Tutic ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Positron Emission Tomography ◽  
Ct Imaging ◽  
Emission Tomography ◽  
Whole Body ◽  
Benign Tumors ◽  
Positron Emission ◽  
Pet Ct ◽  
The Impact

Purpose The aim of this prospective study was to assess the incidence and the nature of solitary extrapulmonary [18F] fluorodeoxyglucose (FDG) accumulations in patients with non–small-cell lung cancer (NSCLC) staged with integrated positron emission tomography and computed tomography (PET/CT) and to evaluate the impact on management. Patients and Methods A total of 350 patients with NSCLC underwent whole-body PET/CT imaging. All solitary extrapulmonary FDG accumulations were evaluated by histopathology, further imaging, or clinical follow-up. Results PET/CT imaging revealed extrapulmonary lesions in 110 patients. In 72 patients (21%), solitary lesions were present. A diagnosis was obtained in 69 of these patients, including 37 (54%) with solitary metastases and 32 (46%) with lesions unrelated to the lung primary. Histopathologic examinations of these 32 lesions revealed a second clinically unsuspected malignancy or a recurrence of a previous diagnosed carcinoma in six patients (19%) and a benign tumor or inflammatory lesion in 26 patients (81%). The six malignancies consisted of carcinoma of the breast in two patients, and carcinoma of the orbit, esophagus, prostate, and non-Hodgkin's lymphoma in one patient each. Benign tumors and inflammatory lesions included eight colon adenomas, four Warthin's tumors, one granuloma of the lower jaw, one adenoma of the thyroid gland, one compensatory muscle activity due to vocal chord palsy, two occurrences of arthritis, three occurrences of reflux esophagitis, two occurrences of pancreatitis, two occurrences of diverticulitis, one hemorrhoidal inflammation, and one rib fracture. Conclusion Solitary extrapulmonary FDG accumulations in patients with newly diagnosed lung cancer should be analyzed critically for correct staging and optimal therapy, given that up to half of the lesions may represent unrelated malignancies or benign disease.

Utilidad de la tomografía por emisión de positrones/tomografía computada (PET/CT) en pacientes con diagnóstico de meduloblastoma

2020 ◽  
Vol 63 (1) ◽  
pp. 34-41
Author(s):  
Rocío Elizabeth García Dávila ◽  
Sergio Díaz Bello ◽  
Raúl Villanueva Rodríguez ◽  
René López León ◽  
Luis Valencia Vázquez
Keyword(s):  
Positron Emission Tomography ◽  
Central Nervous System ◽  
Nervous System ◽  
Somatostatin Receptors ◽  
Emission Tomography ◽  
Imaging Method ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg

"PET/CT (positron emission tomography/computed tomography, for its acronym in English) is a unique imaging method that provides in vivo evidence of both biochemical and physiological activities of the brain, spinal cord and tumors that involve these structures. Medulloblastoma is the most common malignant tumor of the central nervous system (CNS) in pediatric patients, so PET/CT plays an important role as it provides information on the grade and extent of the tumor as well as to determine the appropriate site for the biopsy, assessing the response to the treatment and the patient’s prognosis. There are different radiopharmaceuticals for the evaluation of central nervous system tumors, but 18F FDG (Fluor-2-fluoro-2-desoxy-D-glucose) and 68Ga-DOTA-NOC (68Ga-DOTA0-1NaI3-octreotide) have been studied to help us evaluate and follow up patients diagnosed with medulloblastoma. Medulloblastoma has an overexpression of glucose transporters, mainly type 1, and an overexpression of predominantly type 2 somatostatin receptors, which allows a high affinity for these radiopharmaceuticals. Key words: Medulloblastoma; positron emission tomography; PET/C; 18F-FDG; 68Ga-DOTA-NOC; brain tumor.

Detection of nociceptive-related metabolic activity in the spinal cord of low back pain patients using 18F-FDG PET/CT

2017 ◽  
Vol 15 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Xiaoliang Zhou ◽  
Peter Cipriano ◽  
Brian Kim ◽  
Harpreet Dhatt ◽  
Jarrett Rosenberg ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Positron Emission Tomography ◽  
Low Back Pain ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Low Back ◽  
Spinal Nerves ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct

AbstractBackgroundOver the past couple of decades, a number of centers in the brain have been identified as important sites of nociceptive processing and are collectively known as the ‘pain matrix.’ Imaging tools such as functional magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) have played roles in defining these pain-relevant, physiologically active brain regions. Similarly, certain segments of the spinal cord are likely more metabolically active in the setting of pain conditions, the location of which is dependent upon location of symptoms. However, little is known about the physiologic changes in the spinal cord in the context of pain. This study aimed to determine whether uptake of 18F-FDG in the spinal cord on positron emission tomography/computed tomography (PET/CT) of patients with low back pain (LBP) differs from that of patients without LBP.MethodsWe conducted a retrospective review of 18F-FDG PET/CT scans of 26 patients with non-central nervous system cancers, 13 of whom had reported LBP and 13 of whom were free of LBP (controls). No patients had spinal stenosis or significant 18F-FDG contribution of degenerative changes of the spine into the spinal canal. Circular regions of interests were drawn within the spinal canal on transaxial images, excluding bony or discal elements of the spine, and the maximum standardized uptake value (SUVmax) of every slice from spinal nerves C1 to S1 was obtained. SUVmax were normalized by subtracting the SUVmax of spinal nerve L5, as minimal neural tissue is present at this level. Normalized SUVmax of LBP patients were compared to those of LBP-free patients at each vertebral level.ResultsWe found the normalized SUVmax of patients with LBP to be significantly greater than those of control patients when jointly tested at spinal nerves of T7, T8, T9 and T10 (p < 0.001). No significant difference was found between the two groups at other levels of the spinal cord. Within the two groups, normalized SUVmax generally decreased cephalocaudally.ConclusionsPatients with LBP show increased uptake of 18F-FDG in the caudal aspect of the thoracic spinal cord, compared to patients without LBP.ImplicationsThis paper demonstrates the potential of 18F-FDG PET/CT as a biomarker of increased metabolic activity in the spinal cord related to LBP. As such, it could potentially aid in the treatment of LBP by localizing physiologically active spinal cord regions and guiding minimally invasive delivery of analgesics or stimulators to relevant levels of the spinal cord.

scholarly journals Targeting Stereotactic Body Radiotherapy on Metabolic PET- and Immuno-PET-Positive Vertebral Metastases

Biomedicines ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. 548
Author(s):  
Baptiste Pichon ◽  
Caroline Rousseau ◽  
Audrey Blanc-Lapierre ◽  
Gregory Delpon ◽  
Ludovic Ferrer ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Stereotactic Body Radiotherapy ◽  
Metastatic Breast ◽  
Target Volume ◽  
Emission Tomography ◽  
Vertebral Metastases ◽  
Positron Emission ◽  
Pet Ct ◽  
Target Volumes ◽  
The Impact

(1) Background: Stereotactic body radiotherapy (SBRT) for vertebral metastases (VM) allows the delivery of high radiation doses to tumors while sparing the spinal cord. We report a new approach to clinical target volume (CTV) delineation based on anti-carcinoembryonic antigen (CEA) positron emission tomography (pretargeted immuno-PET; “iPET”) in patients with metastatic breast cancer (BC) or medullary thyroid cancer (MTC). (2) Methods: All patients underwent iPET, spine magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) using 18F-deoxyglucose (FDG) for BC or 18F-dihydroxy-phenylalanine (F-DOPA) for MTC. Vertebrae locations and vertebral segments of lesions were recorded and the impact on CTV delineation was evaluated. (3) Results: Forty-six VM eligible for SBRT following iPET were evaluated in eight patients (five BC, three MTC). Eighty-one vertebral segments were detected using MRI, 26 with FDG or F-DOPA PET/CT, and 70 using iPET. iPET was able to detect more lesions than MRI for vertebral bodies (44 vs. 34). iPET-based delineation modified MRI-based CTV in 70% (32/46) of cases. (4) Conclusion: iPET allows a precise mapping of affected VM segments, and adds complementary information to MRI in the definition of candidate volumes for VM SBRT. iPET may facilitate determining target volumes for treatment with stereotactic body radiotherapy in metastatic vertebral disease.

scholarly journals F-18 Fluorodeoxy Glucose Positron Emission Tomography/Computed Tomography Findings in a Rare Case of Penile Leiomyosarcoma

2011 ◽  
Vol 1 ◽  
pp. 58 ◽  
Author(s):  
Kuruva Manohar ◽  
Bhagwant Rai Mittal ◽  
Raghava Kashyap ◽  
Anish Bhattacharya ◽  
Nandita Kakkar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Penile Cancer ◽  
Rare Case ◽  
Emission Tomography ◽  
Rare Entity ◽  
Positron Emission ◽  
Pet Ct ◽  
Ct Features

Penile cancer is a rare entity accounting for only 0.4% all male malignancies. Penile leiomyosarcomas are even rarer with only around 35 cases reported in literature. We report a rare case of penile leiomyosarcoma illustrating F-18 Fluorodeoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) features and histopathology correlation.

scholarly journals Diagnostic performance of 18F-DCFPyL positron emission tomography/computed tomography for biochemically recurrent prostate cancer and change-of-management analysis

2020 ◽  
Vol 15 (6) ◽  
Author(s):  
Guillaume Chaussé ◽  
Noah Ben-Ezra ◽  
Michelle Stoopler ◽  
Jeremy Y. Levett ◽  
Tamim Niazi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Diagnostic Performance ◽  
Emission Tomography ◽  
Tumor Board ◽  
Recurrent Prostate Cancer ◽  
Positron Emission ◽  
Pet Ct ◽  
The Impact

Introduction: Conventional imaging (CI) performs poorly to identify sites of disease in biochemically recurrent prostate cancer. 68Ga-PSMA-11 positron emission tomography/ computed tomography (PET/CT) is most studied but has a very short half-life. This study reports the diagnostic performance of the novel prostate-specific membrane antigen (PSMA) radiotracer 18F-DCFPyL using real-life data, and tumor board simulation to estimate the impact of 18F-DCFPyL PET on patient management. Methods: Ninety-three 18F-DCFPyL PET/CT scans performed for patients previously treated for prostate cancer with a rising prostate-specific antigen (PSA) were retrospectively compared to contemporary CI, and clinical, imaging and PSA followups. A chart review was performed to document prior imaging, pathology results, serial serum PSA measurements, and other pertinent clinical data. Clinical utility of 18F-DCFPyL PET was measured using a simulated tumor board formed by three physicians with extensive prostate cancer experience deciding on management with and without knowledge of PET/CT results. Results: At median PSA 2.27 (interquartile range [IQR] 5.27], 82% of 18F-DCFPyL PET/CT demonstrated at least one site of disease: non-regional lymph nodes (37% of scans), regional lymph node metastases (28%), local recurrence (27%), bone metastases (20%), with higher PET positivity at higher PSA. Compared to 18F-DCFPyL PET/CT, CI showed overall poor performance, with accuracy below 20% for all extent of disease. PET/CT changed management in 44% of cases. The most frequent scenario was a radical change from initiating androgen deprivation therapy (ADT) to stereotactic body radiotherapy (SBRT) of oligo-lesional disease. In univariate and multivariate analysis, no patient characteristic could predict change of management by PET/CT results. Conclusions: 18F-DCFPyL significantly outperforms CI in recurring prostate cancer and is likely to impact management.

scholarly journals 18F-fluoroethyl-L-tyrosine positron emission tomography-guided diagnosis of a malignant intramedullary spinal cord tumor

2016 ◽  
Vol 12 (6) ◽  
pp. 4705-4707
Author(s):  
Sied Kebir ◽  
Okka Kimmich ◽  
Pitt Niehusmann ◽  
Florian C. Gaertner ◽  
Markus Essler ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Positron Emission Tomography ◽  
Spinal Cord Tumor ◽  
Emission Tomography ◽  
Intramedullary Spinal Cord ◽  
Intramedullary Spinal Cord Tumor ◽  
Positron Emission

Impact of maximum standardized uptake value (SUVmax) evaluated by 18-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG PET/CT) on survival for patients with advanced renal cell carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4626-4626 ◽  
Author(s):  
Noboru Nakaigawa ◽  
Masahiro Yao ◽  
Ukihide Tateishi ◽  
Ryogo Minamimoto ◽  
Hiroji Uemura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Standardized Uptake Value ◽  
Emission Tomography ◽  
Maximum Standardized Uptake Value ◽  
Positron Emission ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
The Impact

4626 Background: In this era of molecular targeting therapy when various systematic treatments can be selected, prognostic biomarkers are required for the purpose of risk-directed therapy selection. Numerous reports of various malignancies have revealed that 18-Fluoro-2-deoxy-D-glucose (18F-FDG) accumulation, as evaluated by positron emission tomography, can be used to predict the prognosis of patients. The purpose of this study was to evaluate the impact of the maximum standardized uptake value (SUVmax) from 18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG PET/CT) on survival for patients with advanced renal cell carcinoma (RCC). Methods: A total of 67 patients with advanced or metastatic RCC were enrolled in this study. The FDG uptake of all RCC lesions diagnosed by conventional CT was evaluated by FDG PET/CT. The impact of SUVmax on patient survival was analyzed prospectively. Results: The mean duration of observation was 461 days (range, 7-1229 days). The SUVmax before treatment of 67 patients ranged between undetectable level and 16.6 (mean 7.6±3.6). The patients with RCC tumors showing high SUVmax before treatment demonstrated poor prognosis (p<0.001 hazard ratio 1.289, 95% CI 1.161-1.430). The median survival time of 36 patients with RCC showing SUVmax less or 7.0 was 1229±991 days, that of 21 patients with RCC showing SUVmax between 7.0 and 12.0 was 446±202 days, and that of 10 patients RCC showing SUVmax higher than 12.0 was 95±43 days (≤7.0 vs. 7.0< ≤12.0 p=0.0052, 7.0< ≤12.0 vs. 12.0<:p=0.0169, log-rank test). SUVmax demonstrated a tendency to predict the survival compared with the Memorial Sloan-Kettering Cancer Center classification (p =0.015 vs 0.315, multivariate Cox analyses). Conclusions: The survival of patients with advanced RCC can be predicted by evaluating their SUVmax using FDG PET/CT. FDG PET/CT has potency as an “imaging biomarker” to provide helpful information for the clinical decision-making.

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