Advanced imaging techniques in CNS lymphoma
| Imaging Method | Findings in CNS Lymphoma | Potential Value as Diagnostic Tool in CNS Lymphoma |
|---|---|---|
| MRI/CT | ||
| Diffusion MRI/diffusion tensor imaging | Restricted diffusion in lesions (hyperintense on DWI and hypointense on ADC maps)40,44–47 | Differentiation of CNS lymphoma and malignant glioma/metastases |
| Decreased FA values in lesions47 | ||
| Perfusion MRI/perfusion CT/permeability MRI | Low maximum CBV40,41 | Differentiation of CNS lymphoma and malignant glioma/metastases |
| Characteristic intensity time curve related to leakage of contrast into the interstitial space41 | Assessment of microvascular tumor permeability relevant for diagnosis, prognostication, and therapy | |
| MR spectroscopy | Elevated lipid peaks and high Cho/Cr ratios29,42–44,59 | Differentiation of CNS lymphoma and some gliomas and CNS lymphomas and toxoplasmosis/PML in AIDS patients |
| High-resolution SWI | Blood products and calcifications are rare findings14,27 | Differentiation of CNS lymphoma and high-grade gliomas |
| MRI with new contrast agents | MRI with iron oxide nanoparticles: lesions enhance less than with gadolinium56 | Differentiation of CNS lymphoma and MS |
| Metabolic imaging | ||
| PET | FDG-PET, methionine PET: hypermetabolic lesions with increased uptake of FDG or methionine25,60,62 | Differentiation of CNS lymphoma and gliomas/metastases/meningiomas |
| Early evaluation of therapeutic response | ||
| SPECT/SPET | Hypermetabolic lesions with high N-isopropyl iodoamphetamine or thallium-201 uptake9,63,64 | Differentiation of AIDS-related CNS lymphoma and infectious intracranial lesions |