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Intramedullary spinal cord metastases: visibility on PET and correlation with MRI features
P M Mostardi1, F E Diehn, J B Rykken
1Mayo Medical School.
AJNR. American Journal of Neuroradiology
|July 27, 2013
Summary
Positron emission tomography (PET) can detect most intramedullary spinal cord metastases when performed with MR imaging. However, these metastases may be missed in clinical PET reports, highlighting the need for careful spinal cord assessment.
Area of Science:
- Oncology
- Radiology
- Nuclear Medicine
Background:
- Systematic evaluations of PET for intramedullary spinal cord metastasis detection are limited.
- Intramedullary spinal cord metastasis detection is crucial for timely diagnosis and treatment.
Purpose of the Study:
- To evaluate the visibility of intramedullary spinal cord metastasis on PET scans.
- To correlate PET findings with MR imaging features of these metastases.
Main Methods:
- Retrospective review of 10 PET examinations in 10 patients with confirmed intramedullary spinal cord metastasis via MR imaging.
- PET scans were reviewed by blinded and unblinded readers.
- PET findings were correlated with MR imaging characteristics.
Main Results:
- PET detected 77% of intramedullary spinal cord metastases in a blinded review.
- Larger lesion size, greater T2 signal abnormality extent, and a higher ratio of T2 abnormality to enhancement on MR imaging correlated with PET visibility.
- Clinical PET reports only identified 38% of the metastases.
Conclusions:
- PET can detect most intramedullary spinal cord metastases when performed concurrently with MR imaging.
- Larger lesions with increased edema are more likely to be visible on PET.
- Careful, specific assessment of the spinal cord on PET is essential for accurate diagnosis.
