Contribution of F-18 FDG PET-CT in the detection of systemic spread of primary central nervous system lymphoma

Dimitrios Karantanis, Brian P. O'Neill, Rathan M. Subramaniam, Patrick J. Peller, Robert J. Witte, Brian P. Mullan, Gregory A. Wiseman

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

PURPOSE: Primary central nervous system lymphoma (PCNSL) accounts for ∼3% of all primary brain tumors and 1% of all non-Hodgkin lymphomas. Detection of systemic spread of PCNSL, although rare (4%), is very important since therapy is usually modified. Contrast-enhanced computed tomography (CT) is commonly used for systemic staging of PCNSL. No previous case report is available in the published literature elaborating the potential contribution of F-18 FDG PET in systemic staging of PCNSL. The purpose of this case report was to document the potential usefulness of F-18 FDG-PET in the detection of occult systemic involvement in PCNSL. MATERIALS AND METHODS: A 50-year-old, immunocompetent, male patient completed successful treatment of PCNSL. As part of a routine pretransplant evaluation he had an F-18 FDG PET coregistered with CT (PET-CT). The PET-CT results were then compared with those of contrast-enhanced CT of the chest, abdomen, and pelvis. RESULTS: The PET-CT examination detected multiple sites of extranodal systemic disease that were not seen in the contrast-enhanced CT of the chest, abdomen, and pelvis (both studies were performed within 24 hours of each other). Percutaneous ultrasound guided biopsy confirmed the presence of systemic spread of PCNSL. The patient's subsequent therapy was modified to include rituximab with cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP). A follow up PET-CT confirmed resolution of systemic spread. CONCLUSION: F-18 FDG PET coregistered to CT may be a useful examination in the detection and monitoring for systemic spread of the disease in PCNSL patients.

Original languageEnglish (US)
Pages (from-to)271-274
Number of pages4
JournalClinical Nuclear Medicine
Volume32
Issue number4
DOIs
StatePublished - Apr 1 2007

Fingerprint

Lymphoma
Central Nervous System
Tomography
Pelvis
Abdomen
Thorax
Vincristine
Prednisone
Brain Neoplasms
Non-Hodgkin's Lymphoma
Doxorubicin
Cyclophosphamide
Therapeutics
Biopsy

Keywords

  • FDG
  • PCNSL
  • PET-CT
  • Primary CNS lymphoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Contribution of F-18 FDG PET-CT in the detection of systemic spread of primary central nervous system lymphoma. / Karantanis, Dimitrios; O'Neill, Brian P.; Subramaniam, Rathan M.; Peller, Patrick J.; Witte, Robert J.; Mullan, Brian P.; Wiseman, Gregory A.

In: Clinical Nuclear Medicine, Vol. 32, No. 4, 01.04.2007, p. 271-274.

Research output: Contribution to journalArticle

Karantanis, Dimitrios ; O'Neill, Brian P. ; Subramaniam, Rathan M. ; Peller, Patrick J. ; Witte, Robert J. ; Mullan, Brian P. ; Wiseman, Gregory A. / Contribution of F-18 FDG PET-CT in the detection of systemic spread of primary central nervous system lymphoma. In: Clinical Nuclear Medicine. 2007 ; Vol. 32, No. 4. pp. 271-274.
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AU - Karantanis, Dimitrios

AU - O'Neill, Brian P.

AU - Subramaniam, Rathan M.

AU - Peller, Patrick J.

AU - Witte, Robert J.

AU - Mullan, Brian P.

AU - Wiseman, Gregory A.

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N2 - PURPOSE: Primary central nervous system lymphoma (PCNSL) accounts for ∼3% of all primary brain tumors and 1% of all non-Hodgkin lymphomas. Detection of systemic spread of PCNSL, although rare (4%), is very important since therapy is usually modified. Contrast-enhanced computed tomography (CT) is commonly used for systemic staging of PCNSL. No previous case report is available in the published literature elaborating the potential contribution of F-18 FDG PET in systemic staging of PCNSL. The purpose of this case report was to document the potential usefulness of F-18 FDG-PET in the detection of occult systemic involvement in PCNSL. MATERIALS AND METHODS: A 50-year-old, immunocompetent, male patient completed successful treatment of PCNSL. As part of a routine pretransplant evaluation he had an F-18 FDG PET coregistered with CT (PET-CT). The PET-CT results were then compared with those of contrast-enhanced CT of the chest, abdomen, and pelvis. RESULTS: The PET-CT examination detected multiple sites of extranodal systemic disease that were not seen in the contrast-enhanced CT of the chest, abdomen, and pelvis (both studies were performed within 24 hours of each other). Percutaneous ultrasound guided biopsy confirmed the presence of systemic spread of PCNSL. The patient's subsequent therapy was modified to include rituximab with cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP). A follow up PET-CT confirmed resolution of systemic spread. CONCLUSION: F-18 FDG PET coregistered to CT may be a useful examination in the detection and monitoring for systemic spread of the disease in PCNSL patients.

AB - PURPOSE: Primary central nervous system lymphoma (PCNSL) accounts for ∼3% of all primary brain tumors and 1% of all non-Hodgkin lymphomas. Detection of systemic spread of PCNSL, although rare (4%), is very important since therapy is usually modified. Contrast-enhanced computed tomography (CT) is commonly used for systemic staging of PCNSL. No previous case report is available in the published literature elaborating the potential contribution of F-18 FDG PET in systemic staging of PCNSL. The purpose of this case report was to document the potential usefulness of F-18 FDG-PET in the detection of occult systemic involvement in PCNSL. MATERIALS AND METHODS: A 50-year-old, immunocompetent, male patient completed successful treatment of PCNSL. As part of a routine pretransplant evaluation he had an F-18 FDG PET coregistered with CT (PET-CT). The PET-CT results were then compared with those of contrast-enhanced CT of the chest, abdomen, and pelvis. RESULTS: The PET-CT examination detected multiple sites of extranodal systemic disease that were not seen in the contrast-enhanced CT of the chest, abdomen, and pelvis (both studies were performed within 24 hours of each other). Percutaneous ultrasound guided biopsy confirmed the presence of systemic spread of PCNSL. The patient's subsequent therapy was modified to include rituximab with cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP). A follow up PET-CT confirmed resolution of systemic spread. CONCLUSION: F-18 FDG PET coregistered to CT may be a useful examination in the detection and monitoring for systemic spread of the disease in PCNSL patients.

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