Radiological abnormalities in progressive multifocal leukoencephalopathy: Identifying typical and atypical imaging

Neetu Soni1, Manish Ora2, Rajiv Mangla3

  • 1Radiodiagnosis (Neuroradiology and Nuclear Medicine), University of Rochester Medical Center, Rochester, NY 14618, USA.

Insights

Progressive multifocal leukoencephalopathy (PML) is a rare CNS disease in immunocompromised individuals. Early recognition of imaging abnormalities is key for timely immune restoration and better patient outcomes.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Progressive multifocal leukoencephalopathy (PML) is a rare, opportunistic viral infection of the central nervous system (CNS).
  • PML primarily affects individuals with compromised immune systems, including those with HIV/AIDS, lymphoproliferative disorders, and multiple sclerosis.
  • Risk factors also include the use of immunomodulatory therapies, chemotherapy, and organ or bone marrow transplantation.

Purpose of the Study:

  • To provide a practical overview of radiological findings in PML.
  • To highlight typical and atypical imaging abnormalities associated with PML.
  • To discuss differential diagnoses for PML, particularly in high-risk patient groups.

Main Methods:

  • This is a review article.
  • It synthesizes current knowledge on PML imaging.
  • It focuses on radiological features and differential diagnoses.

Main Results:

  • PML presents with diverse imaging abnormalities on various radiological modalities.
  • Accurate recognition of these findings is crucial for early diagnosis.
  • Differentiating PML from other CNS conditions is essential, especially in immunocompromised patients.

Conclusions:

  • Early diagnosis of PML through radiological assessment is critical.
  • Prompt identification facilitates timely immune system restoration.
  • Effective management strategies can lead to favorable patient outcomes.