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Central Nervous System Lymphoma: Characteristic Findings on Traditional and Advanced Imaging

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TLDR
New CT and MR imaging techniques and metabolic imaging have demonstrated characteristic findings in CNS lymphoma, aiding in its differentiation from other CNS lesions, and advanced imaging techniques may, in the future, substantially improve the diagnostic accuracy of imaging, ultimately facilitating a noninvasive method of diagnosis.
Abstract
CNS lymphoma consists of 2 major subtypes: secondary CNS involvement by systemic lymphoma and PCNSL. Contrast-enhanced MR imaging is the method of choice for detecting CNS lymphoma. In leptomeningeal CNS lymphoma, representing two-thirds of secondary CNS lymphomas, imaging typically shows leptomeningeal, subependymal, dural, or cranial nerve enhancement. Single or multiple periventricular and/or superficial contrast-enhancing lesions are characteristic of parenchymal CNS lymphoma, representing one-third of secondary CNS lymphomas and almost 100% of PCNSLs. New CT and MR imaging techniques and metabolic imaging have demonstrated characteristic findings in CNS lymphoma, aiding in its differentiation from other CNS lesions. Advanced imaging techniques may, in the future, substantially improve the diagnostic accuracy of imaging, ultimately facilitating a noninvasive method of diagnosis. Furthermore, these imaging techniques may play a pivotal role in planning targeted therapies, prognostication, and monitoring treatment response.

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Journal ArticleDOI

Imaging for Staging and Response Assessment in Lymphoma

TL;DR: An overview of the updated CT and PET response criteria for lymphoma staging and response assessment is provided to familiarize the radiologist with the most important and clinically relevant aspects of lymphoma imaging.
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Primary Central Nervous System Lymphoma and Atypical Glioblastoma: Multiparametric Differentiation by Using Diffusion-, Perfusion-, and Susceptibility-weighted MR Imaging

TL;DR: Combined evaluation of mean ADC, mean rCBV, and presence of ITSS allowed reliable differentiation of PCNSL and atypical glioblastoma in most patients, and these results support an integration of advanced MR imaging techniques for the routine diagnostic workup of patients with these tumors.
Journal ArticleDOI

A Systematic Approach to the Diagnosis of Suspected Central Nervous System Lymphoma

TL;DR: A combined stepwise systematic approach outlined here may facilitate an expeditious, comprehensive presurgical evaluation for cases of suspected CNS lymphoma.
Journal ArticleDOI

Primary central nervous system lymphoma and atypical glioblastoma: Differentiation using radiomics approach

TL;DR: Large-scale radiomics with a machine-learning algorithm can be useful for differentiating PCNSL from atypical GBM, and yields a better diagnostic performance than human radiologists and ADC values.
Journal ArticleDOI

Diffusion radiomics as a diagnostic model for atypical manifestation of primary central nervous system lymphoma: development and multicenter external validation.

TL;DR: The diffusion radiomics model had good generalizability and yielded a better diagnostic performance than conventional radiomics or single advanced MRI in identifying atypical PCNSL mimicking glioblastoma.
References
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Journal ArticleDOI

CNS prophylaxis in lymphoma: Who to target and what therapy to use

TL;DR: CNS prophylaxis for selected patients with DLBCL may be justified by risk but its benefit is not yet proven and in combination with intrathecal methotrexate would be a reasonable option for proPHylaxis.
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Primary lymphoma of the central nervous system: typical and atypical CT and MR imaging appearances.

TL;DR: The use of computed tomography of the head may decrease the need of arteriography for tumor localization as discussed by the authors, which may also reduce the need for arteriograph for tumor detection.
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CT and MR Imaging Features of Primary Central Nervous System Lymphoma in Norway, 1989-2003

TL;DR: White matter periventricular contrast-enhancing single or multiple focal lesions were typical of non-AIDS PCNSL, and no or disseminated lesions heightened the risk of delayed or postmortem diagnosis.
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Differentiating primary central nervous system lymphoma from glioma in humans using localised proton magnetic resonance spectroscopy

TL;DR: It is found that massively elevated lipid resonances are a hallmark of PCNSL in immunocompetent patients and together with a markedly elevated Cho/Cr ratio, MRS provides metabolic information which may improve the preoperative differentiation of PC NSL and glioma.
Journal ArticleDOI

Primary CNS lymphoma: clinical presentation, pathological classification, molecular pathogenesis and treatment

TL;DR: According to the results of uncontrolled studies the combination of RT and chemotherapy based on high-dose methotrexate (HD-MTX) is most efficient in terms of survival rates, however, long-term neurotoxicity overshadows treatment efficacy, especially in patients over 60 years of age.
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