The Utility of Multiparametric Magnetic Resonance Imaging in Reducing Diagnostic Uncertainty for Primary Central Nervous System Lymphoma.
World Neurosurg
; 188: e71-e80, 2024 Aug.
Article
en En
| MEDLINE
| ID: mdl-38740086
ABSTRACT
BACKGROUND:
A key limitation in treatment initiation in primary central nervous system lymphoma (PCNSL) is the diagnostic delay caused by lack of recognition of a lesion as a possible lymphoma, steroid initiation, and lesion involution, often resulting in an inconclusive biopsy result. We highlight the importance of multiparametric magnetic resonance imaging (MRI), which incorporates diffusion-weighted imaging, dynamic susceptibility contrast-enhanced perfusion-weighted imaging, and proton magnetic resonance spectroscopy in addition to standard MRI sequences in resolving diagnostic uncertainty for PCNSL.METHODS:
At our center, a consecutive series of 10 patients with histology-proven PCNSL (specifically, diffuse large B-cell lymphoma of the central nervous system) underwent multiparametric MRI. We retrospectively analyzed qualitative and semiquantitative parameters and assessed their radiological concordance for this diagnosis.RESULTS:
We noted overall low apparent diffusion coefficient on diffusion-weighted imaging (mean minimum apparent diffusion coefficient of 0.74), high percentage signal recovery on perfusion-weighted imaging (mean 170%), a high choline-to-creatine ratio, and a high-grade lipid peak on proton magnetic resonance spectroscopy giving an appearance of twin towers. Of 10 patients, 9 had MRI findings concordant for PCNSL, defined as at least 3 of 4 parameters being consistent for PCNSL.CONCLUSIONS:
Concordance between these imaging multiparametric modalities could be used as a radiological predictor of PCNSL, reducing diagnostic delays, providing a more accurate biopsy target, and resulting in quicker treatment initiation.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias del Sistema Nervioso Central
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Imágenes de Resonancia Magnética Multiparamétrica
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
World Neurosurg
Asunto de la revista:
NEUROCIRURGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido