MRI is currently the standard imaging modality for spinal tumors as it delineates the accurate spinal anatomy and classifies it as being an intra/extramedullary and intradural/extradural in location, the extent of involvement and associated findings like cord edema/ syringomyelia which aid to establish a preliminary preoperative diagnosis for further surgical management. Since the abnormalities seen on PET/MRI may sometimes be less extensive than the abnormalities seen on MRI, PET and MRI may synergistically demonstrate discretely the most metabolically active part of the tumor, edema and other cord changes being non-avid. Since residual intramedullary tumors of the spinal cord are not always easily distinguished from radionecrosis, PET/MRI could add useful information in the assessment of residual/recurrent disease post-treatment.
48 year male, follow up case of PNET in the right frontal region operated in Aug ’12; Post RT and CT. On follow up. Presented with headache, vomiting and seizures. 18 F- FDG PET/MRI was done to evaluate the craniospinal axis.
FDG PET /MRI revealed no enhancing lesion or abnormal tracer uptake in the operated bed in the right frontal region in post-contrast T1 W axial images (A) and PET axial images (B). However, marked diffuse and nodular leptomeningeal enhancement in the supra and infratentorial compartments with effaced sulcal spaces and basal cisterns was seen in T1 W post-contrast axial image (C) No appreciable tracer uptake is noted in relation to it on PET / MR fused images (D) Also, contrast MRI of the spine (E, F) revealed marked diffuse leptomeningeal enhancement encircling and compressing the entire cord and cauda equina with focal heterogeneous FDG uptake(G) along the cauda equina nerve roots suggestive of possible leptomeningeal spread in craniospinal axis. CSF done was positive for malignancy
This short PET-MRI Scan case was compiled by Dr. Sangeeta Taneja and Dr. Amarnath Jena (Nuclear Medicine Physician at PET-Suite @ Indraprastha Apollo Hospital, Sarita Vihar).
Read More about PET-MRI Scan at House Of Diagnostics in Delhi and NCR.
The Simultaneous PET-MRI Scan is currently offered at PET-Suite at Apollo Hospital, Sarita Vihar.