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Journal of Neuro-Oncology
Published in: Journal of Neuro-Oncology 2/2018

01-06-2018 | Topic Review

Diagnosis of non-osseous spinal metastatic disease: the role of PET/CT and PET/MRI

Authors: Ali Batouli, John Braun, Kamal Singh, Ali Gholamrezanezhad, Bethany U. Casagranda, Abass Alavi

Published in: Journal of Neuro-Oncology | Issue 2/2018

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Abstract

The spine is the third most common site for distant metastasis in cancer patients with approximately 70% of patients with metastatic cancer having spinal involvement. Positron emission tomography (PET), combined with computed tomography (CT) or magnetic resonance imaging (MRI), has been deeply integrated in modern clinical oncology as a pivotal component of the diagnostic work-up of patients with cancer. PET is able to diagnose several neoplastic processes before any detectable morphological changes can be identified by anatomic imaging modalities alone. In this review, we discuss the role of PET/CT and PET/MRI in the diagnostic management of non-osseous metastatic disease of the spinal canal. While sometimes subtle, recognizing such disease on FDG PET/CT and PET/MRI imaging done routinely in cancer patients can guide treatment strategies to potentially prevent irreversible neurological damage.
Literature
1.
Witham TF, Khavkin YA, Gallia GL, Wolinsky J-P, Gokaslan ZL (2006) Surgery insight: current management of epidural spinal cord compression from metastatic spine disease. Nat Clin Pract Neurol 2:87–94CrossRefPubMed
2.
3.
Buchbender C, Heusner TA, Lauenstein TC, Bockisch A, Antoch G (2012) Oncologic PET/MRI, part 2: bone tumors, soft-tissue tumors, melanoma, and lymphoma. J Nucl Med 53:1244–1252CrossRefPubMed
4.
5.
Torigian DA, Kjær A, Zaidi H, Alavi A (2016) PET/MR imaging: clinical applications. PET Clin 11:xi–xiiCrossRefPubMed
6.
Reddy Gorla AK, Mittal BR, Bhattacharya A, Malhotra P, Varma S (2015) Heterogeneous marrow uptake on FDG PET/CT is not always a sign of lymphomatous involvement. World J Nucl Med 15:59–61
7.
Cook GJ, Maisey MN, Fogelman I (1999) Normal variants, artefacts and interpretative pitfalls in PET imaging with 18-fluoro-2-deoxyglucose and carbon-11 methionine. Eur J Nucl Med 26:1363–1378CrossRefPubMed
8.
Bordalo-Rodrigues M, Galant C, Lonneux M, Clause D, Vande Berg BC (2003) Focal nodular hyperplasia of the hematopoietic marrow simulating vertebral metastasis on FDG positron emission tomography. Am J Roentgenol 180:669–671CrossRef
9.
Shigematsu Y et al (2014) Distinguishing imaging features between spinal hyperplastic hematopoietic bone marrow and bone metastasis. AJNR Am J Neuroradiol 35:2013–2020CrossRefPubMed
10.
Lim C et al (2015) Incidental focal 18F-FDG uptake on the spinal cord in patients with cancer: prevalence and risk of malignancy. J Nucl Med 56:1419–1419
11.
Greenspan RL, Suprenant V, Atem F (2012) Visualization of distal spinal cord on F-18 FDG PET/CT. Clin Nucl Med 37:137–141CrossRefPubMed
12.
Mosavi F et al (2012) Whole-body diffusion-weighted MRI compared with 18F-NaF PET/CT for detection of bone metastases in patients with high-risk prostate carcinoma. Am J Roentgenol 199:1114–1120CrossRef
13.
14.
Valotassiou V, Leondi A, Angelidis G, Psimadas D, Georgoulias P (2012) SPECT and PET imaging of meningiomas. Sci World J. 2012:1–11CrossRef
15.
Grant R, Papadopoulos SM, Sandler HM, Greenberg HS (1994) Metastatic epidural spinal cord compression: current concepts and treatment. J Neurooncol 19:79–92CrossRefPubMed
16.
Rodriguez M, Dinapoli RP (1980) Spinal cord compression: with special reference to metastatic epidural tumors. Mayo Clin Proc 55:442–448PubMed
17.
Schiff D, O’Neill BP, Suman VJ (1997) Spinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach. Neurology 49:452–456CrossRefPubMed
18.
Moog F, Kotzerke J, Reske SN (1999) FDG PET can replace bone scintigraphy in primary staging of malignant lymphoma. J Nucl Med 40:1407–1413PubMed
19.
Marom EM et al (1999) Staging non-small cell lung cancer with whole-body PET. Radiology 212:803–809CrossRefPubMed
20.
Metser U et al (2004) Malignant involvement of the spine: assessment by 18F-FDG PET/CT. J Nucl Med 45:279–284PubMed
21.
Uchida K et al (2013) 18 F-FDG PET/CT for diagnosis of osteosclerotic and osteolytic vertebral metastatic lesions: comparison with bone scintigraphy. Asian Spine J 7:96CrossRefPubMedPubMedCentral
22.
Antoch G et al (2003) Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology. JAMA 290:3199CrossRefPubMed
23.
Taira AV, Herfkens RJ, Gambhir SS, Quon A (2007) Detection of bone metastases: assessment of integrated FDG PET/CT imaging 1. Radiology 243:204–211CrossRefPubMed
24.
25.
Ho L, Henderson R, Luong T, Malkhassian S, Wassef H (2012) 18F-FDG PET/CT appearance of metastatic brachial plexopathy involving epidural space from breast carcinoma. Clin Nucl Med 37:e263–e264CrossRefPubMed
26.
Probst S, Mayo J, Moskovits T, Friedman K (2011) The appearance of epidural extranodal marginal zone lymphoma (MALToma) on F-18 FDG PET/CT and post hoc PET/MRI fusion. Clin Nucl Med 36:303–304CrossRefPubMed
27.
Ho L, Valenzuela D, Negahban A, Wassef H (2010) Primary spinal epidural non-hodgkin lymphoma demonstrated by FDG PET/CT. Clin Nucl Med 35:487–489CrossRefPubMed
28.
29.
30.
Kim JK et al (2000) Diagnosis of vertebral metastasis, epidural metastasis, and malignant spinal cord compression: are T1-weighted sagittal images sufficient? Magn Reson Imaging 18:819–824CrossRefPubMed
31.
Kim HJ et al (1999) Spinal involvement of hematopoietic malignancies and metastasis: differentiation using MR imaging. Clin Imaging 23:125–133CrossRefPubMed
32.
Yuh WT et al (1989) Vertebral compression fractures: distinction between benign and malignant causes with MR imaging. Radiology 172:215–218CrossRefPubMed
33.
Beiderwellen K et al (2014) Whole-body [18F]FDG PET/MRI vs. PET/CT in the assessment of bone lesions in oncological patients: initial results. Eur Radiol 24:2023–2030CrossRefPubMed
34.
35.
36.
37.
Short RG, Bal S, German JP, Poelstra RJ, Kardan A (2014) Potential of F-18 PET/CT in the detection of leptomeningeal metastasis. Neuroradiol J 27:685–689CrossRefPubMedPubMedCentral
38.
Grande MLD et al (2014) Leptomeningeal carcinomatosis as only pathological finding at FDG-PET/CT in case of tumor marker elevation in breast cancer. Indian J Nucl Med 29:53–54CrossRefPubMedPubMedCentral
39.
Riaz S, Naz F, Bashir H, Niazi IK (2016) ‘Bottle Brush Sign’—spinal meningeal disease on 18F-FDG PET-CT scan. Clin Nucl Med 41:726–727CrossRefPubMed
40.
Solnes LB, Javadi MS, Rowe SP (2016) 18F-FDG PET/CT imaging of cauda equina syndrome secondary to leptomeningeal metastatic breast cancer. Clin Nucl Med 41:e485–e486CrossRefPubMed
41.
Intriago B et al (2011) 18F-FDG PET detection of spinal leptomeningeal metastases from cerebral glioblastoma multiforme. Eur J Nucl Med Mol Imaging 38:1392–1392CrossRefPubMed
42.
Tripathi M et al (2009) Demonstration of diffuse leptomeningeal metastasis in a treated case of medulloblastoma with F-18 FDG PET/CT. Clin Nucl Med 34:530–532CrossRefPubMed
43.
Papasozomenos H et al (2015) Association between 18F-FDG PET/CT and MRI appearance of spinal leptomeningeal disease before and after treatment at a tertiary referral center. J Solid Tumors 6:1CrossRef
44.
Schöder H et al (2005) Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol 23:4643–4651CrossRefPubMed
45.
Barp A, Cecchin D, Cagnin A (2016) PET/MRI imaging unmasks leptomeningeal carcinomatosis in unexplained diplopia. J Neurooncol 126:205–207CrossRefPubMed
46.
Mostardi PM et al (2014) Intramedullary spinal cord metastases: visibility on PET and correlation with MRI features. Am J Neuroradiol 35:196–201CrossRefPubMed
47.
Chason JL, Walker FB, Landers JW (1963) Metastatic carcinoma in the central nervous system and dorsal root ganglia. A prospective autopsy study. Cancer 16:781–787CrossRefPubMed
48.
Gilardi L, Vassallo S, Colandrea M, Travaini LL, Paganelli G (2013) Intramedullary spinal cord metastases from breast cancer: detection with (18)F-FDG PET/CT. Ecancermedicalscience 7:329PubMedPubMedCentral
49.
Sung W-S et al (2013) Intramedullary spinal cord metastases: a 20-year institutional experience with a comprehensive literature review. World Neurosurg 79:576–584CrossRefPubMed
50.
Sari O, Kaya B, Kara Gedik G, Ozcan Kara P, Varoglu E (2012) Intramedullary metastasis detected with 18F FDG-PET/CT. Rev Esp Med Nucl Imagen Mol 31:299–300PubMed
51.
Nguyen NC, Sayed MM, Taalab K, Osman MM (2008) Spinal cord metastases from lung cancer: detection with F-18 FDG PET/CT. Clin Nucl Med 33:356–358CrossRefPubMed
52.
Komori T, Delbeke D (2011) Leptomeningeal Carcinomatosis and intramedullary spinal cord metastases from lung cancer: detection with FDG positron emission tomography. Clin Nucl Med 26:905–907CrossRef
53.
Jayasundera MV, Thompson JF, Fulham MJ (1997) Intramedullary spinal cord metastasis from carcinoma of the lung: detection by positron emission tomography. Eur J Cancer 33:508–509CrossRefPubMed
54.
Faugeras L, Cantineau G, Daisne J-F, Gustin T, D’hondt L (2015) Intramedullary spinal cord metastasis of cholangiocarcinoma: a case report. BMC Res Notes 8:41CrossRefPubMedPubMedCentral
55.
Kawamoto T, Yamashita T, Kaito S, Miura Y (2016) Intramedullary spinal cord metastasis from breast cancer mimicking delayed radiation myelopathy: detection with 18F-FDG PET/CT. Nucl Med Mol Imaging (2010) 50:169–170CrossRef
56.
Törnwall J, Snäll J, Mesimäki K (2008) A rare case of spinal cord metastases from oral SCC. Br J Oral Maxillofac Surg 46:594–595CrossRefPubMed
Metadata
Title
Diagnosis of non-osseous spinal metastatic disease: the role of PET/CT and PET/MRI
Authors
Ali Batouli
John Braun
Kamal Singh
Ali Gholamrezanezhad
Bethany U. Casagranda
Abass Alavi
Publication date
01-06-2018
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 2/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-018-2794-8

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