Intramedullary Spinal Cord Metastases: Visibility on PET and Correlation with MRI Features

Abstract

BACKGROUND AND PURPOSE:Studies systematically evaluating the detection of intramedullary spinal cord metastasis with PET are lacking. Our purpose was to evaluate the visibility of intramedullary spinal cord metastasis on PET in a single institutional series and to correlate PET and MR imaging features.

Intramedullary Spinal Cord Metastases: Prognostic Value of MRI and Clinical Features from a 13-Year Institutional Case Series

“…2 A previous study had categorized the presence or absence of uptake of these ISCMs on PET, when this was available, within 60 days prior or 14 days after the correlative pretreatment diagnostic MR imaging. 3 Note that a previously published analysis 2 of the 70 ISCMs in the current study demonstrated that most of the lesions had a convincing appearance of being intramedullary rather than leptomeningeal in origin. Specifically, only 4 of the lesions were exophytic on MR imaging, and in all 4 of these cases, the interpreting radiologist had described an intramedullary mass extending exophytically, rather than a leptomeningeal mass invading the parenchyma.…”

“…1 Moreover, multiple MR imaging characteristics have been characterized in detail 2 and correlated with findings on physiologic imaging with PET. 3 However, the prognostic value of MR imaging and clinical findings has not been assessed, to our knowledge. A recent literature review of 301 patients noted that there are no evidence-based treatment guidelines for ISCMs and that the various therapeutic options do not generally considerably affect survival.…”

Intramedullary metastases detected on 18F FDG-PET/CT imaging

“…Most intramedullary metastases are diagnosed with contrast-enhanced MRI. In literature, there are few case reports [1][2][3][4][5]. In a case report of neurosarcoidosis with isolated involvement of the spinal cord case the authors reported FDG PET/ CT unmasking a great mimicker [6].…”

Interpretation of MR Imaging of Spinal Metastasis: Focus on the Understanding of Its Pathophysiology and the Next Step toward a Further Clinical Approach Using MRI Findings

“…Early detection is very important because appropriate treatment of intramedullary spinal cord metastasis may slow the rate of neurologic complication (19,20).…”