Imaging characteristics of an atypical spinal angiolipoma on PET/CT and MRI

Li, Yuhao; Luo, Ruxin; Zhang, Wenjie; Li, Lin

doi:10.1016/j.remnie.2024.500015

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In this study, a significant reduction in size, from 63 mm to 16 mm in the main axis, and in metabolic activity of the primary lesion, SULpeak from 5.37 to 2.82, were observed, consistent with partial metabolic response according to PERCIST criteria. Following this, the patient completed the five cycles of the IVA regimen and was referred for brachytherapy to complete the treatment." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Rivas-Navas, T. Rudolphi-Solero, J. Fernández-Fernández, J. Villa-Palacios, C. Ramos-Font" "autores" => array:5 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Rivas-Navas" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Rudolphi-Solero" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Fernández-Fernández" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Villa-Palacios" ] 4 => array:2 [ "nombre" => "C." 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Axial PET/CT views of the (B, C) head region revealed a mildly hypermetabolic right nasal mass lesion with an SUVmax of 4.9 (arrows). [68Ga]Ga-DOTA-TOC MIP and axial PET/CT head views (D-F) clearly depicted intense expression within the right nasal mass (SUVmax of 22.8). Axial, and sagittal T1 brain MRI (G, H) images exposed a single hyperintense right sinonasal mass. Axial and sagittal views of fused PET/MR (I, J) head views denoted precise and intense localization within the recurrent nasal meningioma, measuring about 3.6 in maximum dimension." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ahmed S. Abdlkadir, Rula Amarin, Enrique Estrada-Lobato, Akram Al-Ibraheem" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ahmed S." "apellidos" => "Abdlkadir" ] 1 => array:2 [ "nombre" => "Rula" "apellidos" => "Amarin" ] 2 => array:2 [ "nombre" => "Enrique" "apellidos" => "Estrada-Lobato" ] 3 => array:2 [ "nombre" => "Akram" "apellidos" => "Al-Ibraheem" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S2253654X24000222" "doi" => "10.1016/j.remn.2024.500014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253654X24000222?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000314?idApp=UINPBA00004N" "url" => "/22538089/0000004300000004/v3_202408070927/S2253808924000314/v3_202408070927/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Interesting images" "titulo" => "Imaging characteristics of an atypical spinal angiolipoma on PET/CT and MRI" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Yuhao Li, Ruxin Luo, Wenjie Zhang, Lin Li" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Yuhao" "apellidos" => "Li" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "fn0005" ] ] ] 1 => array:3 [ "nombre" => "Ruxin" "apellidos" => "Luo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "1" "identificador" => "fn0005" ] ] ] 2 => array:2 [ "nombre" => "Wenjie" "apellidos" => "Zhang" ] 3 => array:4 [ "nombre" => "Lin" "apellidos" => "Li" "email" => array:1 [ 0 => "lilinhuaxi@sina.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Características de imagen de un angiolipoma espinal atípico en PET/TC y resonancia magnética (RM)" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1977 "Ancho" => 2925 "Tamanyo" => 354761 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "The spine MRI revealed this lesion had low signal intensity on sagittal T1-weighted image (A) and high signal intensity on sagittal (B) and axial T2-weighted image (C), with uneven enhancement after injection of contrast (D, E, F)." ] ] ] "textoCompleto" => "A 42-year-old man complained with lower back pain for one year. The laboratory examination, including blood routine examination and tumor marker, was normal. The spine MRI revealed bone lesion in the left pedicle of L1 vertebral body. This lesion had low signal intensity on sagittal T1-weighted image and high signal intensity on sagittal and axial T2-weighted image (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A–C), which had a size of 2.0×0.8×1.7cm with uneven enhancement after injection of contrast (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D–F). While MRI favored a benign tumor, malignancy cannot be excluded. To further characterize the nature of the lesion, FDG PET/CT image was performed. The sagittal CT, PET, fusion image (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A–C), and axial CT, PET, fusion image (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>D–F) and the Maximum Intensity Projection (MIP) image (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>G) demonstrated bone destruction of the left pedicle with slight FDG uptake in comparison with the surrounding bone marrow (SUVmax: 3.13). The metabolic behaviour orientates to a benign nature, supporting MRI findings. Subsequently, due to worsening pain symptoms, surgical intervention was pursued, resulting in the resection of the left pedicle tumor. Postoperative pathology supported a diagnosis of angiolipoma with fibrous tissue proliferation. Spinal angiolipoma account for approximately 0.04% to 1.2% of all spinal tumors,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> traditionally classified into non-invasive and invasive subtypes. Characteristic MRI findings of spinal angiolipoma typically comprise a spindle-shaped lesion adhering to the dura mater in the sagittal plane, and a discernible displacement of the spinal cord towards the contralateral side, often exhibiting a “noodle” sign.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> FDG PET/CT image of spinal angiolipoma is rarely reported. Shen et al. reported a case of invasive spinal angiolipoma, presenting as bone destruction with spinal cord compression and mild FDG uptake on FDG PET/CT, highlighting the importance of distinguishing it from other malignant bone tumors.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Our case only manifested as bone destruction without any spinal cord compression, which may hint non-invasive subtype. Our case revealed atypical imaging features of spinal angiolipoma on PET/CT and MRI, emphasizing the need for differentiation from other benign bone tumors (e.g., osteoblastoma, giant cell tumor of bone) in clinical practice.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>FundingNone to declare by all authors.Conflict of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "Yuhao Li and Ruxin Luo contributed equally to this work and shared joint first authorship." "identificador" => "fn0005" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1977 "Ancho" => 2925 "Tamanyo" => 354761 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "The spine MRI revealed this lesion had low signal intensity on sagittal T1-weighted image (A) and high signal intensity on sagittal (B) and axial T2-weighted image (C), with uneven enhancement after injection of contrast (D, E, F)." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2149 "Ancho" => 2925 "Tamanyo" => 412795 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "The sagittal CT (A), PET (B), fusion image (C), and axial CT (D), PET (E), fusion image (F) and the Maximum Intensity Projection (MIP) image (G) demonstrated bone destruction of the left pedicle with slight FDG uptake in comparison with the surrounding bone marrow." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal angiolipoma-a rare but reversible cause of paraplegia in a child" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.A. Jaiswal" 1 => "G. Divakar" 2 => "K. Krishnakumar" 3 => "A. Karthikayan" 4 => "Y. Sawakare" 5 => "R. Mhatre" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00381-020-04542-5" "Revista" => array:5 [ "tituloSerie" => "Childs Nerv Syst" "fecha" => "2020" "volumen" => "36" "paginaInicial" => "1121" "paginaFinal" => "1125" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal angiolipoma: a report of two cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Wang" 1 => "H. Tang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0300060520954690" "Revista" => array:3 [ "tituloSerie" => "J Int Med Res" "fecha" => "2020" "volumen" => "48" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PET/CT and MR features of infiltrating spinal angiolipoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Shen" 1 => "M. Su" 2 => "A. Kuang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0000000000002410" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2019" "volumen" => "44" "paginaInicial" => "e148" "paginaFinal" => "e150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30516665" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004300000004/v3_202408070927/S2253808924000302/v3_202408070927/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000004300000004/v3_202408070927/S2253808924000302/v3_202408070927/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808924000302?idApp=UINPBA00004N"]

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The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles. The works may be submitted in Spanish or English and are subjected to a peer review process. In 2009, it became the leading Spanish journal in the field of Medical Imaging on having an Impact Factor , awarded by the Journal Citation Reports.

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