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.
23 year old female is a known case of Grade III ependymoma. The patient was operated in May’12 following which RT and chemotherapy were given. PET /MRI was done on 19/10/13 which revealed metabolically active deposits in the spine.
Sagittal post-contrast MRI (A, C )reveals enhancing nodular deposits in the entire spinal canal.FDG PET/ MR fused images (B,D) reveal increased FDG uptake in the enhancing lesions suggesting drop metastasis. CSF was positive for malignant cells. MRI is the imaging modality of choice for the craniospinal axis. Twin investigations viz., FDG PET and MRI using simultaneous PET MR ( Biograph mMR) does a comprehensive evaluation of the entire craniospinal axis in the single examination and thereby increasing the sensitivity and specificity of either examination used alone.
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.