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¹⁸F-FDG PET/CT Findings of Leptomeningeal Metastasis in Nasopharyngeal Carcinoma

Montanarella, Matthew DO^∗; Boldig, Kimberly DO^†; Natter, Patrick MD^∗; Ozdemir, Savas MD^∗

From the ^∗Department of Radiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL

^†Department of Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.

Conflicts of interest and sources of funding: none declared.

Received for publication August 11, 2022; revision accepted October 23, 2022.

Contributorship: All authors contributed to project conception, manuscript preparation, and manuscript editing.

Correspondence to: Matthew Montanarella, DO, Department of Radiology, University of Florida College of Medicine-Jacksonville, 655 W 8th St, Jacksonville, FL 32209. E-mail: [email protected].

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Clinical Nuclear Medicine 48(2):p 201-202, February 2023. | DOI: 10.1097/RLU.0000000000004499

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Abstract

FU1 — FIGURE 1:
Sagittal T1 (A) and postcontrast T1 fat-saturated (B) MR of the lumbar spine demonstrate an enhancing lesion in the spinal canal at the level of the sacrum (arrow). MIP image of PET/CT (C) and sagittal fused PET/CT (D) demonstrate diffuse FDG-avid spinal leptomeningeal metastasis with SUV_max of 32. The findings are easily discernible on PET/CT.^1–8 Also noted are FDG-avid left cervical and supraclavicular nodal metastasis on MIP image. Traditionally, CSF cytology and MRI have been used in the diagnosis of leptomeningeal metastasis.^9–11 PET/CT has shown utility in this case by accentuating the extent of disease.

REFERENCES

1. Malik D. FDG PET/CT in recurrent glioblastoma multiforme with leptomeningeal and diffuse spinal cord metastasis. Clin Nucl Med. 2021;46:138–139.

Google Scholar

2. Wang CJ, Wang CY. Nasopharyngeal carcinoma with leptomeningeal dissemination: case report. Chang Gung Med J. 2000;23:118–122.

Google Scholar

3. Liaw CC, Ho YS, Koon-Kwan NG, et al. Nasopharyngeal carcinoma with brain metastasis: a case report. J Neurooncol. 1994;22:227–230.

Google Scholar

4. Li AC, Xiao WW, Shen GZ, et al. Distant metastasis risk and patterns of nasopharyngeal carcinoma in the era of IMRT: long-term results and benefits of chemotherapy. Oncotarget. 2015;6:24511–24521.

Google Scholar

5. Lee O, Cromwell LD, Weider DJ. Carcinomatous meningitis arising from primary nasopharyngeal carcinoma. Am J Otolaryngol. 2005;26:193–197.

Google Scholar

6. Chen YP, Chan ATC, Le QT, et al. Nasopharyngeal carcinoma. Lancet. 2019;394:64–80.

Google Scholar

7. Short RG, Bal S, German JP, et al. Potential of F-18 PET/CT in the detection of leptomeningeal metastasis. Neuroradiol J. 2014;27:685–689.

Google Scholar

8. Lu Y, Wang L, Ajani JA. Rare esophageal leptomeningeal metastases detected on ¹⁸F-FDG PET/CT. Clin Nucl Med. 2020;45:334–335.

Google Scholar

9. Arslan E, Erol O, Beyhan E, et al. Detection of cauda equine syndrome with ¹⁸F-FDG PET/CT and leptomeningeal metastasis by ⁶⁸Ga-DOTATATE in the same patient with large cell neuroendocrine carcinoma of lung. Clin Nucl Med. 2021;46:488–490.

Google Scholar

10. Mohite A, Agrawal A, Purandare N, et al. Congenital melanocytic nevi syndrome with leptomeningeal melanoma. Clin Nucl Med. 2022;Publish ahead of print.