Qualitative Assessment of Diffusion Weighted Imaging and Susceptibility Weighted Imaging of Myeloid Sarcoma Involving the Brain

Chaudhry, Ammar; Gul, Maryam; Chaudhry, Abbas; Dunkin, Jared

doi:10.1097/rct.0000000000000337

Cited by 13 publications

(15 citation statements)

References 21 publications

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“…There are a few studies that have previously systematically analyzed CNS MS. Shinagare et al [ 14 ] and Chaudhry et al [ 15 ] both described brain MS lesions showing isointensity on T1WI, hyperintensity on T2WI and hyperintensity on FLAIR sequences. Similar to our study, their qualitative assessment of lesions demonstrated a restricted diffusion on DWI and revealed few susceptibility artifacts on GRE.…”

Section: Discussionmentioning

confidence: 99%

“…There are several case reports [ 8 , 9 ] and pictorial essays [ 10 ] in radiology literature that report on image performance in MS, however, there exists only 5 small studies that systematically analyzed MS [ 11 – 15 ]. Choi et al [ 11 ] previously reported computed tomography (CT) findings of MS involving the bowel, and Noh et al [ 12 ] first reported CT findings of MS involving the head and neck.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, Shinagare et al [ 14 ] systematically reviewed and described multisystem CT and MRI (T1WI, T2WI and T1 post-contrast) characteristics of MS, but only 6 patients with central nervous system involvement were studied. Moreover, Chaudhry et al [ 15 ] described CT and MRI (T1WI, T2WI and contrast-enhanced T1WI, DWI and SWI) characteristics of MS involving the brain. None of these studies systematically performed qualitative and quantitative analysis of diffusion and perfusion characteristics of MS, and none of these studies assessed treatment response of MS using MRI.…”

Section: Introductionmentioning

confidence: 99%

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Use of magnetic resonance imaging for diagnosis and after treatment of patients with myeloid sarcoma of the brain

Hou¹,

Du²,

et al. 2017

Oncotarget

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The purpose of this retrospective study was to assess the utility of magnetic resonance imaging (MRI) for evaluating post-treatment responses in patients with myeloid sarcoma (MS) of the brain. We evaluated images from both conventional and advanced MR, including diffusion weighted imaging (DWI), arterial spin labeling (ASL) and susceptibility weighted imaging (SWI). Parameters of our qualitative review included lesion location, number, size, morphologic characteristics, surrounding edema, mass effect, pattern and degree of enhancement, ± restricted diffusion, ±susceptibility artifact and ± higher perfusion. Our quantitative assessments were calculated from DW and ASL MR images. The 10 patients had a total of 40 lesions in their brains (mean lesion size of 2.0 ± 0.8 cm). The majority of cases exhibited restricted diffusion (90%) and mild-to-moderate low perfusion (80%). Follow-up MRI after chemotherapy revealed that most lesions (80%) were significantly alleviated after two chemotherapy courses and further improved after four courses. Only a few lesions (5%) were residual after six courses. These findings demonstrate that brain MS can be characterized by changes in various MRI parameters and that MRI can be a useful and predictive assessment tool for brain MS diagnosis and treatment management.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of magnetic resonance imaging for diagnosis and after treatment of patients with myeloid sarcoma of the brain

Hou¹,

Du²,

et al. 2017

Oncotarget

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show abstract

“…Enhanced homogenous soft tissue masses at multiple sites strongly suggest the presence of an MS, especially when a hematological disorder is present. [ 3 , 4 , 6 , 22 , 23 ]…”

Section: Discussionmentioning

confidence: 99%

A myeloid sarcoma involving the small intestine, kidneys, mesentery, and mesenteric lymph nodes

Wang

Li²,

Zhang³

et al. 2017

Medicine

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Rationale:Myeloid sarcomas (MSs) are rare malignant hematological tumors. They most commonly occur in patients with acute or chronic myeloid leukemia. A de novo MS with no evidence of blood system disease is rare, but may represent the first sign of a systemic illness that precedes a full-blown disease. Herein, we report the computed tomography (CT) findings of an extremely rare case of a nonleukemic MS that progressed to acute myelogenous leukemia (AML) and simultaneously involved the small intestine, kidneys, mesentery, and mesenteric lymph nodes. Moreover, we provide CT findings before and after AML chemotherapy, which have not been reported previously.Patient concerns:A 25-year-old man with intermittent upper abdominal pain for 6 months was admitted to the hospital on November 28, 2015. Initial CT showed concentric wall thickening of the jejunum with an adjacent mesenteric soft tissue mass and mesenteric lymph nodes enlargement. Both kidneys were involved as indicated by the presence of well-defined mildly dilated lesions. During the laparoscopic surgery, the small intestinal tumor, mesenteric soft tissue mass, and mesenteric lymph nodes were removed.Diagnoses:The pathological diagnosis was an MS.Interventions:The patient refused systemic chemotherapy and was rehospitalized with persistently aggravated abdominal distension on February 17, 2016. Follow-up CT showed diffuse small bowel wall thickening, widespread infiltration of the peritoneum, omentum, and mesentery, mesenteric lymph node enlargement, and large amounts of ascites fluid. The lesions in both kidneys were substantially larger and more numerous than on initial CT. Then the patient was treated with conventional AML chemotherapy.Outcomes:The patient achieved complete hematological remission on bone marrow examination. Follow-up CT in September 4, 2016, showed none of the abnormalities seen on initial CT. Currently, the patient is in complete remission.Lessons:If the radiological examination shows lesions at multiple sites, and these lesions are soft tissue masses with homogenous enhancement, MS should be considered in the differential diagnosis, and an aspiration biopsy should be performed to provide a definitive pathological diagnosis. If MS is diagnosed, systemic chemotherapy is crucial to recovery; otherwise, the disease may progress rapidly. Medical imaging is helpful for diagnosing MS and for monitoring treatment response.

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“…The radiological features of CNS-MS are typically characterized by the presence of an isodense or hyperdense mass on CT scan images, with marked homogeneous enhancement following contrast agent administration (22). The appearance of CNS-MS via MRI is typically hypointense to isointense on T1-and T2-weighted images, with marked enhancement following the administration of a contrast agent (23,24). Radiological differential diagnoses may include meningioma, lymphoma and schwannoma.…”

Section: Discussionmentioning

confidence: 99%

Clinicoradiological characteristics, management and prognosis of primary myeloid sarcoma of the central nervous system: A report of four cases

Yang¹,

Yang²,

Fang³

et al. 2017

Oncology Letters

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Qualitative Assessment of Diffusion Weighted Imaging and Susceptibility Weighted Imaging of Myeloid Sarcoma Involving the Brain

Cited by 13 publications

References 21 publications

Use of magnetic resonance imaging for diagnosis and after treatment of patients with myeloid sarcoma of the brain

Use of magnetic resonance imaging for diagnosis and after treatment of patients with myeloid sarcoma of the brain

A myeloid sarcoma involving the small intestine, kidneys, mesentery, and mesenteric lymph nodes

Clinicoradiological characteristics, management and prognosis of primary myeloid sarcoma of the central nervous system: A report of four cases

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