Intramedullary spinal cord metastases: Visibility on PET and correlation with MRI features

P. M. Mostardi, Felix E. Diehn, J. B. Rykken, L. J. Eckel, K. M. Schwartz, Timothy J Kaufmann, C. P. Wood, J. T. Wald, C. H. Hunt

Research output: Contribution to journalArticle

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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. MATERIALS AND METHODS: Patients were included if pretreatment MR imaging identifying an intramedullary spinal cord metastasis and an [18F] FDG-PET examination near the time of MR imaging were available. PET examinations were retrospectively reviewed, with reviewers blinded and then unblinded to the PET report and MR imaging findings. PET intramedullary spinal cord metastasis features were compared with and correlated with previously analyzed MR imaging lesion characteristics. Original clinical PET reports were reviewed. RESULTS: The final study sample was 10 PET examinations in 10 patients with 13 intramedullary spinal cord metastases. In 7 (70%) patients, retrospective blinded review demonstrated convincing evidence of 10 (77%) intramedullary spinal cord metastases. Three MR imaging features correlated with intramedullary spinal cord metastases being visible on PET compared with those nonvisible, respectively: larger lesion enhancement size: mean size: 32.1mmversus 6.0mm(P = .038); larger longitudinal extent of T2 signal abnormality: mean 5.6 versus 1.0 segments (P = .0081); and larger ratio of extent of T2 signal abnormality to contrast enhancement: 3.8 versus 1.0 (P = .0069). Intramedullary spinal cord metastasis was confidently reported clinically in 2 (20%) patients, accounting for 5 (38%) intramedullary spinal cord metastases. CONCLUSIONS: Most intramedullary spinal cord metastases can be detected on PET when performed near the time of pretreatment MR imaging. However, intramedullary spinal cord metastases may not be clinically reported on PET. Larger lesions with more edema are more likely to be visible. The spinal cord should be specifically and carefully assessed on PET for evidence of intramedullary spinal cord metastases to provide timely diagnosis.

Original languageEnglish (US)
Pages (from-to)196-201
Number of pages6
JournalAmerican Journal of Neuroradiology
Volume35
Issue number1
DOIs
StatePublished - Jan 2014

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Spinal Cord
Neoplasm Metastasis
Fluorodeoxyglucose F18
Edema

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

Cite this

Mostardi, P. M., Diehn, F. E., Rykken, J. B., Eckel, L. J., Schwartz, K. M., Kaufmann, T. J., ... Hunt, C. H. (2014). Intramedullary spinal cord metastases: Visibility on PET and correlation with MRI features. American Journal of Neuroradiology, 35(1), 196-201. https://doi.org/10.3174/ajnr.A3618

Intramedullary spinal cord metastases : Visibility on PET and correlation with MRI features. / Mostardi, P. M.; Diehn, Felix E.; Rykken, J. B.; Eckel, L. J.; Schwartz, K. M.; Kaufmann, Timothy J; Wood, C. P.; Wald, J. T.; Hunt, C. H.

In: American Journal of Neuroradiology, Vol. 35, No. 1, 01.2014, p. 196-201.

Research output: Contribution to journalArticle

Mostardi, PM, Diehn, FE, Rykken, JB, Eckel, LJ, Schwartz, KM, Kaufmann, TJ, Wood, CP, Wald, JT & Hunt, CH 2014, 'Intramedullary spinal cord metastases: Visibility on PET and correlation with MRI features', American Journal of Neuroradiology, vol. 35, no. 1, pp. 196-201. https://doi.org/10.3174/ajnr.A3618
Mostardi, P. M. ; Diehn, Felix E. ; Rykken, J. B. ; Eckel, L. J. ; Schwartz, K. M. ; Kaufmann, Timothy J ; Wood, C. P. ; Wald, J. T. ; Hunt, C. H. / Intramedullary spinal cord metastases : Visibility on PET and correlation with MRI features. In: American Journal of Neuroradiology. 2014 ; Vol. 35, No. 1. pp. 196-201.
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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. MATERIALS AND METHODS: Patients were included if pretreatment MR imaging identifying an intramedullary spinal cord metastasis and an [18F] FDG-PET examination near the time of MR imaging were available. PET examinations were retrospectively reviewed, with reviewers blinded and then unblinded to the PET report and MR imaging findings. PET intramedullary spinal cord metastasis features were compared with and correlated with previously analyzed MR imaging lesion characteristics. Original clinical PET reports were reviewed. RESULTS: The final study sample was 10 PET examinations in 10 patients with 13 intramedullary spinal cord metastases. In 7 (70{\%}) patients, retrospective blinded review demonstrated convincing evidence of 10 (77{\%}) intramedullary spinal cord metastases. Three MR imaging features correlated with intramedullary spinal cord metastases being visible on PET compared with those nonvisible, respectively: larger lesion enhancement size: mean size: 32.1mmversus 6.0mm(P = .038); larger longitudinal extent of T2 signal abnormality: mean 5.6 versus 1.0 segments (P = .0081); and larger ratio of extent of T2 signal abnormality to contrast enhancement: 3.8 versus 1.0 (P = .0069). Intramedullary spinal cord metastasis was confidently reported clinically in 2 (20{\%}) patients, accounting for 5 (38{\%}) intramedullary spinal cord metastases. CONCLUSIONS: Most intramedullary spinal cord metastases can be detected on PET when performed near the time of pretreatment MR imaging. However, intramedullary spinal cord metastases may not be clinically reported on PET. Larger lesions with more edema are more likely to be visible. The spinal cord should be specifically and carefully assessed on PET for evidence of intramedullary spinal cord metastases to provide timely diagnosis.",
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AU - Mostardi, P. M.

AU - Diehn, Felix E.

AU - Rykken, J. B.

AU - Eckel, L. J.

AU - Schwartz, K. M.

AU - Kaufmann, Timothy J

AU - Wood, C. P.

AU - Wald, J. T.

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N2 - 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. MATERIALS AND METHODS: Patients were included if pretreatment MR imaging identifying an intramedullary spinal cord metastasis and an [18F] FDG-PET examination near the time of MR imaging were available. PET examinations were retrospectively reviewed, with reviewers blinded and then unblinded to the PET report and MR imaging findings. PET intramedullary spinal cord metastasis features were compared with and correlated with previously analyzed MR imaging lesion characteristics. Original clinical PET reports were reviewed. RESULTS: The final study sample was 10 PET examinations in 10 patients with 13 intramedullary spinal cord metastases. In 7 (70%) patients, retrospective blinded review demonstrated convincing evidence of 10 (77%) intramedullary spinal cord metastases. Three MR imaging features correlated with intramedullary spinal cord metastases being visible on PET compared with those nonvisible, respectively: larger lesion enhancement size: mean size: 32.1mmversus 6.0mm(P = .038); larger longitudinal extent of T2 signal abnormality: mean 5.6 versus 1.0 segments (P = .0081); and larger ratio of extent of T2 signal abnormality to contrast enhancement: 3.8 versus 1.0 (P = .0069). Intramedullary spinal cord metastasis was confidently reported clinically in 2 (20%) patients, accounting for 5 (38%) intramedullary spinal cord metastases. CONCLUSIONS: Most intramedullary spinal cord metastases can be detected on PET when performed near the time of pretreatment MR imaging. However, intramedullary spinal cord metastases may not be clinically reported on PET. Larger lesions with more edema are more likely to be visible. The spinal cord should be specifically and carefully assessed on PET for evidence of intramedullary spinal cord metastases to provide timely diagnosis.

AB - 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. MATERIALS AND METHODS: Patients were included if pretreatment MR imaging identifying an intramedullary spinal cord metastasis and an [18F] FDG-PET examination near the time of MR imaging were available. PET examinations were retrospectively reviewed, with reviewers blinded and then unblinded to the PET report and MR imaging findings. PET intramedullary spinal cord metastasis features were compared with and correlated with previously analyzed MR imaging lesion characteristics. Original clinical PET reports were reviewed. RESULTS: The final study sample was 10 PET examinations in 10 patients with 13 intramedullary spinal cord metastases. In 7 (70%) patients, retrospective blinded review demonstrated convincing evidence of 10 (77%) intramedullary spinal cord metastases. Three MR imaging features correlated with intramedullary spinal cord metastases being visible on PET compared with those nonvisible, respectively: larger lesion enhancement size: mean size: 32.1mmversus 6.0mm(P = .038); larger longitudinal extent of T2 signal abnormality: mean 5.6 versus 1.0 segments (P = .0081); and larger ratio of extent of T2 signal abnormality to contrast enhancement: 3.8 versus 1.0 (P = .0069). Intramedullary spinal cord metastasis was confidently reported clinically in 2 (20%) patients, accounting for 5 (38%) intramedullary spinal cord metastases. CONCLUSIONS: Most intramedullary spinal cord metastases can be detected on PET when performed near the time of pretreatment MR imaging. However, intramedullary spinal cord metastases may not be clinically reported on PET. Larger lesions with more edema are more likely to be visible. The spinal cord should be specifically and carefully assessed on PET for evidence of intramedullary spinal cord metastases to provide timely diagnosis.

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