Role of Positron Emission Tomography in Primary Central Nervous System Lymphoma

Abstract

The incidence of primary central nervous system lymphoma has increased over the past two decades in immunocompetent patients and the prognosis remains poor. A diagnosis and complete evaluation of the patient is needed without delay, but histologic evaluation is not always available and PCNSL can mimic a variety of brain lesions on MRI. In this article, we review the potential role of 18F-FDG PET for the diagnosis of PCNSL in immunocompetent and immunocompromised patients. Its contribution to systemic assessment at the time of diagnosis has been well established by expert societies over the past decade. In addition, 18F-FDG provides valuable information for differential diagnosis and outcome prediction. The literature also shows the potential role of 18F-FDG as a therapeutic evaluation tool during the treatment and the end of the treatment. Finally, we present several new radiotracers that may have a potential role in the management of PCNSL in the future.

Primary meningeal central nervous system lymphoma: A case report and literature review

“…Techniques such as 18F-fluorodeoxyglucose PET-CT can aid in the diagnosis of PMCNSL and can exclude systemic disease secondary to central nervous system involvement. [ 9 , 10 ] In this patient, enhanced MRI of the thoracolumbar spine revealed multiple meningeal and partial nerve root enhancements in the thoracolumbar spine, and PET-CT showed increased metabolism of the meninges and some nerve roots at the cerebellar margin, both of which suggested possible malignant meningitis.…”

[18F]FDG PET-MRI provides survival biomarkers in primary central nervous system lymphoma in the elderly: an ancillary study from the BLOCAGE trial of the LOC network

“…This prospective study assessed the value of simultaneous [18F]FDG PET-MRI to provide prognostic biomarkers for PCNSL in immunocompetent elderly patients homogeneously treated with an HD-MTX-based CT regimen at first-line. Currently, age and KPS are the only well-established clinical markers, but they are not sufficient in guiding the management of PCNSL in elderly patients, which has a poor prognosis [23]. The use of hybrid PET-MR system in this study provided the opportunity to compare multimodality data with optimal temporal synchronization and spatial co-registration between both modalities [24] .…”

Neuro-Oncology and Positron Emission Tomography: “Just Can’t Get Enough”

“…This imaging method is useful for assessing the disease spread at the time of diagnosis. In addition, it can provide valuable information for differential diagnosis and outcome prediction, and for treatment response assessment [12].…”