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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Diagnosing neuroleukemiosis: Is there a role for 18F-FDG-PET/CT?
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Vol. 36. Issue 6.
Pages 396-398 (November - December 2017)
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Vol. 36. Issue 6.
Pages 396-398 (November - December 2017)
Clinical note
DOI: 10.1016/j.remnie.2017.09.009
Diagnosing neuroleukemiosis: Is there a role for 18F-FDG-PET/CT?
Diagnosticando la neuroleucemiosis: ¿existe un papel para la PET/TC con 18F-FDG?
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A. Sabaté-Lloberaa,
Corresponding author
asabatell@bellvitgehospital.cat

Corresponding author.
, M. Cortés-Romeraa, E. Gamundí-Grimaltb, J.J. Sánchez-Fernándezc, L. Rodríguez-Bela, C. Gámez-Cenzanoa
a PET Unit, Department of Nuclear Medicine – IDI, Hospital Universitari de Bellvitge – IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
b Hematologic Citology, Department of Pathology, Hospital Universitari de Bellvitge – IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
c Department of Radiology – IDI, Hospital Universitari de Bellvitge – IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
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Abstract

An imaging case is presented on a patient referred to our department for an 18F-FDG-PET/CT, as a paraneoplastic syndrome was suspected due to his clinical situation. He had a history of acute myeloid leukemia (AML) treated two years earlier, with sustained complete remission to date. 18F-FDG-PET/CT findings revealed hypermetabolism in almost all nerve roots, suggesting meningeal spread, consistent with the subsequent MRI findings. Cerebrospinal fluid (CSF) findings confirmed a leptomeningeal reactivation of AML. Although not many studies have evaluated the role of 18F-FDG-PET/CT in leukemia, it is a noninvasive tool for detecting extramedullary sites of disease and a good imaging alternative for those patients on whom an MRI cannot be performed.

Keywords:
FDG
PET/CT
Acute myeloid leukemia
Meningeal relapse
Neuroleukemiosis
Resumen

Presentamos el caso de un paciente remitido a nuestro servicio para la realización de una PET/TC con 18F-FDG por sospecha clínica de un síndrome paraneoplásico Entre sus antecedentes destacaba el de una leucemia mieloide aguda tratada 2 años antes y en remisión completa en los controles sucesivos. La PET/TC con 18F-FDG mostró hipermetabolismo en prácticamente todas las raíces nerviosas, apuntando a enfermedad meníngea diseminada, en concordancia con los hallazgos de la RM realizada posteriormente. El análisis del líquido cefalorraquídeo confirmó una reactivación leptomeníngea de la leucemia mieloide aguda. A pesar de los pocos estudios existentes sobre el papel de la PET/TC con 18F-FDG en la leucemia, es una herramienta no invasiva para localizar recidivas extramedulares de la enfermedad y una buena técnica de imagen alternativa para aquellos pacientes a los que no se les puede realizar una RM.

Palabras clave:
FDG
PET/TC
Leucemia mieloide aguda
Recidiva meníngea
Neuroleucemiosis

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