Limitations Of FDG PET/T Case Study

Limitations of FDG PET and PET/CT and the role of MRI One drawback of PET based imaging is that some tumor types do not demonstrate significant FDG avidity. Schwab JH et al. reported a case of myxoid liposarcoma metastasis to the lumbar spine and paraspinal soft tissues, which was not detected by FDG PET, but easily seen on MRI [19]. In these cases, where FDG PET offers limited sensitivity, other target specific radiotracers or other imaging modalities, such as MRI should be considered. The most useful role for FDG PET/CT in detection of EMD is as a screening tool for neurologically asymptomatic patients undergoing routine cancer workup and follow-up [43]. Once epidural disease has been identified, MRI, the gold standard for spinal imaging, can further delineate anatomic details for radiation therapy or surgical planning purposes [32-34]. On MRI, epidural lesions are most often T1 hypointense and T2 hyperintense with avid enhancement on post …show more content…
A hallmark of ISCM is rapid neurological progression with up to 30-45% of symptomatic patients presenting with Brown-Sequard or pseudo Brown-Sequard Syndrome [28, 52, 59]. Up to 50% of patients with ISCM are asymptomatic until death [51]. However, once symptoms develop, disease course can be devastating with up to 75% of patients experiencing progression to full neurological deficit within one-month and mean survival time of one to four months [28, 52, 53, 60, 61, 63, 71]. Treatment consists primarily of radiation therapy with microdissection more recently coming into the field as a valid alternative [52, 54, 55, 56, 60, 64, 71]. Timely treatment can stabilize or reverse neurological dysfunction, increase quality of life, and prolong survival [52, 54,