scholarly journals Value of Multimodal Imaging Approach to Diagnosis of Neurosarcoidosis

2019 ◽  
Vol 9 (10) ◽  
pp. 243 ◽  
Author(s):  
Ilaria Sammarra ◽  
Gaetano Barbagallo ◽  
Angelo Labate ◽  
Baldassare Mondello ◽  
Giuseppe Albonico ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Fdg Pet ◽  
Whole Body ◽  
Resonance Imaging ◽  
1H Mrs ◽  
3T Mri ◽  
18F Fdg ◽  
Neoplastic Disorders ◽  
Magnetic Resonance Imaging Mri

Background: Neurosarcoidosis is a highly variable condition with many clinical and radiological manifestations, that can lead to difficult identification of isolated central nervous system (CNS) forms, because it could mimic inflammatory, infective or neoplastic disorders. Conventional magnetic resonance imaging (MRI) is gold standard to evaluate CNS involvement in neurosarcoidosis, despite the reported high sensitivity but low specificity in the diagnosis. Case presentation: Here, we describe a 52-year-old man that presented to our hospital with a 10-year history of focal seizures, progressive cognitive decline and motor impairment. Neurological examination revealed ataxic gait, bilateral telekinetic and postural tremor, brisk reflexes, left extensor plantar response and hypoesthesia to the right side of body. Brain 3T-magnetic resonance imaging (MRI) showed a leukoencephalopathy with multifocal nodular lesions hyperintense on T2/ fluid attenuated inversion recovery (FLAIR) weighted images involving basal ganglia, periventricular and deep white matter. The interpretation of this pattern on conventional MRI was unclear, opening a challenge on the differential diagnosis between inflammatory, infective or neoplastic disorders. Thus, to better understand the nature of these nodules, single-voxel 1H-magnetic resonance spectroscopy (1H-MRS), contrast enhanced computed tomography (CT) scan and fluorine-18-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET)/3T-MRI were performed. The parenchymal multifocal lesions exhibited slight N-acetyl-aspartate/creatine reduction without abnormal peaks on 1H-MRS, enhancement after the administration of contrast agent on CT and hypermetabolism on 18F-FDG-PET/3T-MRI. All these findings excluded primary neoplasms, metastasis, neurotuberculosis, neurocysticercosis and brain abscess, strongly suggesting a diagnosis of neurosarcoidosis. Therefore, a whole-body 18F-FDG-PET/CT was performed in order to identify subclinical extraneural sarcoidosis localizations, and a hypermetabolic nodule of the left lung upper lobe was found. Subsequently, a biopsy documented the presence of systemic sarcoidosis, supporting a diagnosis of probable neurosarcoidosis. Conclusions: This case demonstrated that a multimodal neuroimaging approach can provide different but complementary evidences to suspect sarcoidosis, especially in apparently CNS isolated forms.

Clinical significance of diffusion-weighted whole body magnetic resonance imaging with background body signal suppression (DWIBS) as a staging procedure for lymphoma patients in comparison with FDG-PET

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8084-8084
Author(s):  
T. Itoyama ◽  
T. Shibuya ◽  
T. Koga ◽  
M. Kitagawa ◽  
T. Yoshida ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Significance ◽  
Fdg Pet ◽  
Clinical Staging ◽  
Whole Body ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Signal Suppression ◽  
Body Magnetic Resonance Imaging

8084 Background: FDG-PET is thought to be an important staging tool in lymphomas. However, high cost and exposure to radioactive agents are of disadvantage. Diffusion weighted whole body magnetic resonance imaging with background body signal suppression (DWIBS) is recently reported to be a new way of magnetic resonance imaging which can make FDG-PET-like imaging possible to detect tumors (Takahara et al; Radiation Medicine 22: 275–282, 2004). This study is aimed to compare accuracy and clinical significance of DWIBS to FDG - PET. Methods: We examined 19 lymphoma (Ly) patients (pts) by using both DWIBS and FDG -PET at the time of diagnosis before therapy. There were follicular Ly in 3 pts, nodal marginal zone Ly in 1, diffuse large B-cell Ly in 9 including primary stomach Ly in 2, peripheral T -cell Ly in 4, and MALT Ly of stomach (GI-MALT) in 2. DWIBS was performed with a 1.5 -Tesla system as previously reported (Ochiai et al; Nichidoku -Iho 50: 86–98, 2005). Clinical staging was made according to the Ann Arbor classification. Results: Both DWIBS and FDG -PET had positive findings in 18 of 19 pts except for a case of GI -MALT. In nodal lesions, DWIBS was positive in 16 pts at 66 sites compared to 16 pts at 68 sites with FDG -PET. DWIBS was negative in 3 pts at 5 sites in spleen, hilar and mediastinal lymphnodes where positive in FDG -PET. DWIBS was positive in 2 pts at 4 sites in iliac and inguinal lymphnodes that are negative in FDG -PET. In extranodal lesions, DWIBS was positive in 12 pts at 17 sites as compared to 12 pts at 18 sites with FDG -PET. Involvement of bone and stomach were equally identified at 8 sites. DWIBS was negative in 2 pts at 2 sites in liver and pleura with FDG -PET positive. Small skin lesions were clearly identified on DWIBS. Discordance of clinical staging was not observed between DWIBS and FDG -PET. Conclusions: Although some discrepancy was seen between DWIBS and FDG -PET, there was no disadvantage of DWIBS compared to FDG -PET. Furthermore, DWIBS has no risk of radiation exposure and is even advantageous to detect lesions with FDG -PET negative. We conclude DWIBS is a new useful tool to assess tumor spread in lymphomas. No significant financial relationships to disclose.

scholarly journals Whole-body diffusion-weighted magnetic resonance imaging versus FDG-PET/CT for initial lymphoma staging: systematic review on diagnostic test accuracy studies

2015 ◽  
Vol 133 (2) ◽  
pp. 141-150 ◽  
Author(s):  
Rodrigo Regacini ◽  
Andrea Puchnick ◽  
David Carlos Shigueoka ◽  
Wagner Iared ◽  
Henrique Manoel Lederman
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Magnetic Resonance ◽  
Diagnostic Test ◽  
Fdg Pet ◽  
Whole Body ◽  
Test Accuracy ◽  
Resonance Imaging ◽  
Pet Ct ◽  
Fdg Pet Ct

CONTEXT AND OBJECTIVE: Positron emission tomography with [18]F-fluoro-2-deoxyglucose (FDG-PET/CT) has been advocated as the method of choice for lymphoma staging, since it enables whole-body analysis with high sensitivity for detection of affected areas and because it combines capacities for anatomical and functional assessment. With technological advances, magnetic resonance imaging (MRI) has emerged as an alternative to FDG-PET/CT. This systematic review with meta-analysis aimed to compare whole-body diffusion-weighted MRI (WB-MRI) with FDG-PET/CT for lymphoma staging. DESIGN AND SETTING: Systematic review on diagnostic test accuracy studies conducted at a public university. METHODS: The Medline, Scopus, Embase and Lilacs databases were searched for studies published up to September 2013 that compared WB-MRI and FDG-PET/CT for lymphoma staging. The reference lists of included studies were checked for any relevant additional citations. RESULTS: Six studies that evaluated the initial lymphoma staging in 116 patients were included. WB-MRI and FDG-PET/CT agreed in 90.5% of the cases (κ = 0.871; P < 0.0001). In most of the studies, when there was disagreement between the methods, WB-MRI overstaged in relation to FDG-PET/CT. The sensitivity of WB-MRI and FDG-PET/CT, in comparison with the clinical-radiological standard, ranged from 59 to 100% and from 63 to 100% respectively. CONCLUSION: WB-MRI is a highly sensitive method for initial lymphoma staging. It has excellent agreement with FDG-PET/CT and is a great alternative for managing lymphoma patients, without using ionizing radiation or an intravenous contrast agent.

Magnetic Resonance Imaging and Spectroscopy in Schizophrenia

1990 ◽  
Vol 157 (S9) ◽  
pp. 56-65 ◽  
Author(s):  
John L. Waddington ◽  
Eadbhard O'Callaghan ◽  
Conall Larkin ◽  
Oonagh Redmond ◽  
John Stack ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Functional Neuroimaging ◽  
Whole Body ◽  
Resonance Spectroscopy ◽  
Uniform Field ◽  
Resonance Imaging ◽  
New Era ◽  
Imaging And Spectroscopy ◽  
Magnetic Resonance Imaging Mri

In this new era of structural and functional neuroimaging technologies, it is the unsurpassed anatomical resolution of magnetic resonance imaging (MRI) (Andreasen, 1989; and Besson, this supplement) that has resulted in a new generation of studies on cerebral morphology in schizophrenia. With the recent development of whole-body magnets of very high (⩾ 1.5T) and uniform field strength, it has become possible to extend the scope of this approach to include measurement of certain fundamental neurochemical processes, via magnetic resonance spectroscopy (MRS: Hubesch et al, 1989; Lock et al, this supplement). The purpose of this article is to introduce and review critically the existing literature on the application of MRI and MRS to schizophrenia, and to give a preliminary account of some of our own recent studies in these areas.

Selective Non-Excitation of Water or Fat Protons in Magnetic Resonance Imaging

1987 ◽  
Vol 42 (12) ◽  
pp. 1391-1395
Author(s):  
M. Braun ◽  
W. I. Jung ◽  
O. Lutz ◽  
R. Oeschey
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal To Noise Ratio ◽  
Fat Distribution ◽  
Whole Body ◽  
Pulse Excitation ◽  
Resonance Imaging ◽  
Spectral Separation ◽  
Magnetic Resonance Imaging Mri ◽  
Test Objects

Nuclear magnetic resonance imaging (MRI) of water and fat protons has been performed with a 1.5 T whole body imager. The highly selective excitation, necessary for the discrimination of the two proton species, has been achieved by different four and five pulse excitation schemes which had to be adapted to the needs of MRI and completed to imaging sequences. Their ability to produce well separated water and fat distribution images of test objects is demonstrated. The special features of the method such as signal-to-noise ratio, insensitivity to rf-field inhomogeneities, ease of implementation and data handling are discussed and compared to existing spectral separation techniques.

scholarly journals Whole-body magnetic resonance imaging and FDG-PET/CT for lymphoma staging: Assessment of patient experience

2017 ◽  
Vol 48 (4) ◽  
pp. 1043-1047 ◽  
Author(s):  
Domenico Albano ◽  
Francesco Agnello ◽  
Caterina Patti ◽  
Ludovico La Grutta ◽  
Alberto Bruno ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Patient Experience ◽  
Fdg Pet ◽  
Whole Body ◽  
Resonance Imaging ◽  
Pet Ct ◽  
Body Magnetic Resonance Imaging ◽  
Fdg Pet Ct
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