Diagnostic accuracy of SPECT, PET, and MRS for primary central nervous system lymphoma in HIV patients

Yang, Mo; Sun, James; Bai, Harrison X.; Tao, Yongguang; Tang, Xiangqi; States, Lisa J.; Zhang, Zishu; Zhou, Jianhua; Farwell, Michael D.; Zhang, Paul; Xiao, Bo; Yang, Li

doi:10.1097/md.0000000000006676

Cited by 25 publications

(31 citation statements)

References 42 publications

(50 reference statements)

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“…Twenty-four meta-analyses on the use of PET or PET/CT with different tracers in brain tumors, published from 2012, were selected through the comprehensive computer literature search (Figure 1) [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. The characteristics of the selected meta-analyses on the diagnostic performance are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…18 F-FDG PET and PET/CT showed considerable accuracy in identifying PCNSL among various brain lesions in immunocompetent patients (pooled sensitivity and specificity of 88% and 86%, respectively), therefore, 18 F-FDG PET/CT could be a valuable diagnostic imaging method in this setting [22]. High diagnostic accuracy of 18 F-FDG PET and PET/CT has also been demonstrated in identifying PCNSL among various brain lesions in patients with human immunodeficiency virus (HIV) infection [23].…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic Performance and Prognostic Value of PET/CT with Different Tracers for Brain Tumors: A Systematic Review of Published Meta-Analyses

Treglia

Muoio

Trevisi

et al. 2019

IJMS

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Background: Several meta-analyses reporting data on the diagnostic performance or prognostic value of positron emission tomography (PET) with different tracers in detecting brain tumors have been published so far. This review article was written to summarize the evidence-based data in these settings. Methods: We have performed a comprehensive literature search of meta-analyses published in the Cochrane library and PubMed/Medline databases (from inception through July 2019) about the diagnostic performance or prognostic value of PET with different tracers in patients with brain tumors. Results: We have summarized the results of 24 retrieved meta-analyses on the use of PET or PET/computed tomography (CT) with different tracers in brain tumors. The tracers included were: fluorine-18 fluorodeoxyglucose (18F-FDG), carbon-11 methionine (11C-methionine), fluorine-18 fluoroethyltyrosine (18F-FET), fluorine-18 dihydroxyphenylalanine (18F-FDOPA), fluorine-18 fluorothymidine (18F-FLT), and carbon-11 choline (11C-choline). Evidence-based data demonstrated good diagnostic performance of PET with different tracers in detecting brain tumors, in particular, radiolabelled amino acid tracers showed the highest diagnostic performance values. All the PET tracers evaluated had significant prognostic value in patients with glioma. Conclusions: Evidence-based data showed a good diagnostic performance for some PET tracers in specific indications and significant prognostic value in brain tumors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Diagnostic Performance and Prognostic Value of PET/CT with Different Tracers for Brain Tumors: A Systematic Review of Published Meta-Analyses

Treglia

Muoio

Trevisi

et al. 2019

IJMS

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“…The pooled sensitivity and specificity were 92% and 84%, respectively. 88 Figure 5 shows examples of MRS in cerebral toxoplasmosis and SPECT in PCNSL. Interestingly, CSF Epstein-Barr virus (EBV) polymerase chain reaction (PCR) shows sensitivity of 83% to 100% and specificity of 93% to 100% in patients with PCNSL but does not have high diagnostic accuracy to identify PCNSL.…”

Section: Diagnosismentioning

confidence: 99%

HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease

Vidal

2019

J Int Assoc Provid AIDS Care

122

152

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Cerebral toxoplasmosis is the most common cause of expansive brain lesions in people living with HIV/AIDS (PLWHA) and continues to cause high morbidity and mortality. The most frequent characteristics are focal subacute neurological deficits and ring-enhancing brain lesions in the basal ganglia, but the spectrum of clinical and neuroradiological manifestations is broad. Early initiation of antitoxoplasma therapy is an important feature of the diagnostic approach of expansive brain lesions in PLWHA. Pyrimethamine-based regimens and trimethoprim-sulfamethoxazole (TMP-SMX) seem to present similar efficacy, but TMP-SMX shows potential practical advantages. The immune reconstitution inflammatory syndrome is uncommon in cerebral toxoplasmosis, and we now have more effective, safe, and friendly combined antiretroviral therapy (cART) options. As a consequence of these 2 variables, the initiation of cART can be performed within 2 weeks after initiation of antitoxoplasma therapy. Herein, we will review historical and current concepts of epidemiology, diagnosis, and treatment of HIV-related cerebral toxoplasmosis.

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“…Various neuroimaging patterns have been proposed for the diagnosis of toxoplasma lesions to differentiate from primary CNS lymphoma based on MR or other brain imaging modalities. Decreased or poor uptake in toxoplasmosis using singlephoton emission computed tomography (SPECT) and positron emission tomography (PET) has been reported [17,38,39], but cost and availability of these modalities limit their use in the clinical setting, especially in countries with a high prevalence of HIV/AIDS and toxoplasma infections.…”

Section: Discussionmentioning

confidence: 99%

Fulminant and Diffuse Cerebral Toxoplasmosis as the First Manifestation of HIV Infection: A Case Presentation and Review of the Literature

et al. 2020

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Unusual clinical course Background: One of the most common causes of central nervous system (CNS) opportunistic infections in immunocompromised patients is toxoplasmosis. It can cause focal or disseminated brain lesions leading to neurological deficit, coma, and death. Prompt management with optimal antibiotics is vital. However, the diagnosis of cerebral toxoplasmosis is challenging in infected individuals with human immunodeficiency virus (HIV). The possible diagnosis is based on clinical presentation, imaging, and specific serologic investigations. The diagnosis can be confirmed by histopathological examination and/or by finding nucleic material in the spinal cerebrospinal fluid (CSF) examination. Case Report: We present a review of the literature with a rare illustrative case of diffuse CNS toxoplasmosis as the first manifestation of HIV infection in a young patient. Brain MRI showed diffuse, ring-enhancing lesions, and significant midline shift. Decompressive hemicraniectomy for control of intracranial pressure and anti-infectious therapy were performed. Conclusions: This should raise awareness that cerebral toxoplasmosis can occur in pediatric patients with HIV infection, and, more importantly, as the first manifestation of AIDS. Although the prognosis is often poor, early diagnosis and immediate treatment of this life-threatening opportunistic infection can improve outcomes.

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Diagnostic accuracy of SPECT, PET, and MRS for primary central nervous system lymphoma in HIV patients

Abstract: Supplemental Digital Content is available in the text

Cited by 25 publications

References 42 publications

Diagnostic Performance and Prognostic Value of PET/CT with Different Tracers for Brain Tumors: A Systematic Review of Published Meta-Analyses

Diagnostic Performance and Prognostic Value of PET/CT with Different Tracers for Brain Tumors: A Systematic Review of Published Meta-Analyses

HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease

Fulminant and Diffuse Cerebral Toxoplasmosis as the First Manifestation of HIV Infection: A Case Presentation and Review of the Literature

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