Diffuse cortical hypermetabolism of the cerebellum in meningeal carcinomatosis: Assessment with 18F-FDG-PET/CT and MRI

Crombé, Amandine; Cazeau, Anne‐Laure; Cousin, Sophie; Chomy, François; Bacci, Julia; Kind, Michèle

doi:10.1016/j.diii.2019.03.013

Diagnostic and Interventional Imaging

2019

DOI: 10.1016/j.diii.2019.03.013

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Diffuse cortical hypermetabolism of the cerebellum in meningeal carcinomatosis: Assessment with 18F-FDG-PET/CT and MRI

Amandine Crombé¹,

Anne‐Laure Cazeau²,

Sophie Cousin³

et al.

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Cited by 2 publications

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“…The latter finding was unexpected, because the patient experienced no meningism nor neurological deficits, but mere episodical retro-ocular headache. To differentiate between malignant central nervous system (CNS) infiltration [1][2][3][4][5][6][7] and immune-mediated paraneoplastic subacute cerebellar degeneration, 8-10 subsequent investigation with MR and lumbar puncture was carried out. MR showed nonspecific cerebellar edema without substantial leptomeningeal enhancement.…”

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confidence: 99%

Cerebellar Hypermetabolism in a Hodgkin Lymphoma Leads to Diagnosis of Paucisymptomatic Cryptococcus neoformans Meningitis

Vanerwegen,

Ahmadi Bidakhvidi,

Vergote

et al. 2023

Clin Nucl Med

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Malignancy-associated cerebellar hypermetabolism on [ 18 F]FDG PET/CT has 2 major causes: paraneoplastic autoimmune encephalitis and neoplasias (leptomeningeal/cerebellar metastases and primary cerebellar tumors). We present the case of a 33-year-old man with a newly diagnosed Hodgkin lymphoma and mere episodical headache, unexpectedly displaying intense cerebellar hypermetabolism on his staging [ 18 F]FDG PET/CT. Both neurolymphomatosis and paraneoplastic subacute cerebellar degeneration were ruled out by clinical presentation, MR, and repeated lumbar punctures. Instead, cerebrospinal fluid analysis unveiled a Cryptococcus neoformans meningitis, highlighting the possibility of paucisymptomatic central nervous system infections as differential diagnosis in malignancy-related cerebellar hypermetabolism in addition to (para)neoplastic causes.

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mentioning

confidence: 99%

Cerebellar Hypermetabolism in a Hodgkin Lymphoma Leads to Diagnosis of Paucisymptomatic Cryptococcus neoformans Meningitis

Vanerwegen,

Ahmadi Bidakhvidi,

Vergote

et al. 2023

Clin Nucl Med

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Whole-body 18-F-FDG-PET in patients with leptomeningeal disease and correlation with MRI

Hintermeister

Hunt

Kendi

2020

Nuclear Medicine Communications

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Objective Studies evaluating leptomeningeal disease on whole-body 18F-FDG PET are lacking. The purpose was to evaluate PET imaging of leptomeningeal disease and investigate the incremental utility of newer PET reconstructions in leptomeningeal disease. Methods PET imaging of 56 patients with leptomeningeal disease detected initially on MRI (n = 53) or cytopathology (n = 35) were retrospectively reviewed. Regular 3-dimensional iterative reconstruction (3D IR, n = 56) and advanced reconstruction (AdvRecon, n = 41) PET images were evaluated by readers blinded to clinical and MRI findings for uptake involving cauda equina, posterior fossa and spinal cord. Spinal cord uptake pattern was classified as normal (uptake < liver), uptake = liver, conus uptake > liver, conus and cervical cord uptake > liver and multifocal/diffuse uptake > liver. SUVmax ratios of conus/liver, conus/left atrium and conus/cervical cord were compared between 3D IR and AdvRecon datasets. Results Cauda equina uptake was seen in 64% and 78% on 3D IR and AdvRecon; posterior fossa uptake was seen in 52% and 54% on 3D IR and AdvRecon, respectively. Twelve percent had cauda equina or posterior fossa uptake visible only on AdvRecon. On 3D IR, normal spinal cord uptake was most common (27%); on AdvRecon, conus and cervical cord uptake > liver was most common (32%). Seven of 11 patients with normal spinal cord uptake on 3D IR were upgraded to increased uptake on AdvRecon. AdvRecon showed significantly higher conus/liver, conus/blood pool and conus/cervical cord SUVmax ratios (P < 0.0001). Conclusion Abnormal uptake in cauda equina, posterior fossa and spinal cord uptake are visible on FDG PET in leptomeningeal disease with increased conspicuity advanced PET reconstructions.

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Diffuse cortical hypermetabolism of the cerebellum in meningeal carcinomatosis: Assessment with 18F-FDG-PET/CT and MRI

Cited by 2 publications

References 5 publications

Cerebellar Hypermetabolism in a Hodgkin Lymphoma Leads to Diagnosis of Paucisymptomatic Cryptococcus neoformans Meningitis

Cerebellar Hypermetabolism in a Hodgkin Lymphoma Leads to Diagnosis of Paucisymptomatic Cryptococcus neoformans Meningitis

Whole-body 18-F-FDG-PET in patients with leptomeningeal disease and correlation with MRI

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