Utility of FDG-PETCT and magnetic resonance spectroscopy in differentiating between cerebral lymphoma and non-malignant CNS lesions in HIV-infected patients.
AuthorsWestwood, Thomas D
Julyan, Peter J
Bonington, Suzanne C
Carrington, Bernadette M
AffiliationDepartment of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, United Kingdom. Electronic address: firstname.lastname@example.org.
MetadataShow full item record
AbstractBACKGROUND AND PURPOSE: In HIV infected patients, MRI cannot reliably differentiate between central nervous system (CNS) lymphoma and non-malignant CNS lesions, particularly cerebral toxoplasmosis (CTOX). This study prospectively investigates the utility of FDG PET-CT and magnetic resonance spectroscopy (MRS) in discriminating CNS lymphoma from non-malignant CNS lesions in HIV infected patients, and assesses the ability of FDG PET-CT to guide the use of early brain biopsy. METHODS: 10 HIV patients with neurological symptoms and contrast enhancing lesions on MRI were commenced on anti-toxoplasmosis therapy before undergoing FDG PET-CT and MRS. Brain biopsies were sought in those with FDG PET-CT suggestive of CNS lymphoma, and in those with a negative FDG PET-CT scan who failed to respond to therapy. Final diagnosis was based on histology or treatment response. RESULTS: Two patients were confirmed to have CNS lymphoma and FDG PET-CT was consistent with this diagnosis in both. Six patients had cerebral toxoplasmosis in all of whom FDG PET-CT was consistent with non-malignant disease. One patient had progressive multifocal leukoencephalopathy (PML), FDG PET-CT was equivocal. One patient had a haemorrhagic brain metastasis and FDG PET-CT wrongly suggested non-malignant disease. MRS was performed successfully in eight subjects: three results were suggestive of CNS lymphoma (one true positive, two false positive), four suggested CTOX (two false negative, two true negative), one scan was equivocal. CONCLUSION: FDG PET-CT correctly identified all cases of CNS lymphoma and CTOX, supporting its use in this situation. MRS was unhelpful in our cohort.
CitationUtility of FDG-PETCT and magnetic resonance spectroscopy in differentiating between cerebral lymphoma and non-malignant CNS lesions in HIV-infected patients. 2013: Eur J Radiol
JournalEuropean Journal of Radiology
- ¹⁸F-FDG PET/CT in HIV-related central nervous system pathology.
- Authors: Lewitschnig S, Gedela K, Toby M, Kulasegaram R, Nelson M, O'Doherty M, Cook GJ
- Issue date: 2013 Sep
- FDG-PET in differentiating lymphoma from nonmalignant central nervous system lesions in patients with AIDS.
- Authors: Hoffman JM, Waskin HA, Schifter T, Hanson MW, Gray L, Rosenfeld S, Coleman RE
- Issue date: 1993 Apr
- 18F-FDG PET/CT in evaluating non-CNS pediatric malignancies.
- Authors: Tatsumi M, Miller JH, Wahl RL
- Issue date: 2007 Dec
- Assessment of multifocality and axillary nodal involvement in early-stage breast cancer patients using 18F-FDG PET/CT compared to contrast-enhanced and diffusion-weighted magnetic resonance imaging and sentinel node biopsy.
- Authors: Ergul N, Kadioglu H, Yildiz S, Yucel SB, Gucin Z, Erdogan EB, Aydin M, Muslumanoglu M
- Issue date: 2015 Aug
- Evaluation of staging and early response to chemotherapy with whole-body diffusion-weighted MRI in malignant lymphoma patients: A comparison with FDG-PET/CT.
- Authors: Tsuji K, Kishi S, Tsuchida T, Yamauchi T, Ikegaya S, Urasaki Y, Fujiwara Y, Ueda T, Okazawa H, Kimura H
- Issue date: 2015 Jun