原发性中枢神经系统淋巴瘤(PCNSL)的高级分子和病理生理学表征揭示了对有希望的靶向治疗方法的见解。医学影像在PCNSL诊断中起着基础性作用,分期,和反应评估。机构影像学变化和不一致的临床试验报告降低了临床反应评估的可靠性和可重复性。在这种情况下,我们的目的是:(1)严格审查使用先进的正电子发射断层扫描(PET)和磁共振成像(MRI)在PCNSL的设置;(2)提供从临床网站的国际调查结果描述常规和先进的成像的现行做法,(3)提供国际PCNSL协作组(IPCG)关于适应标准化成像实践的生物学建议。IPCG提供PET和MRI共识建议,建立在先前针对原发性和转移性疾病的标准化脑肿瘤成像方案(BTIP)的建议基础上。提供了一种生物整合方法来解决与PCNSL的成像评估相关的独特挑战。详细的成像参数有助于研究人员和临床医生采用这些建议。为了提高临床可行性,我们在3T和1.5TMR系统中开发了“理想”和“最低标准”协议,这将促进广泛采用。
Advanced molecular and pathophysiologic characterization of primary central nervous system lymphoma (
PCNSL) has revealed insights into promising targeted therapeutic approaches. Medical imaging plays a fundamental role in
PCNSL diagnosis, staging, and response assessment. Institutional imaging variation and inconsistent clinical trial reporting diminishes the reliability and reproducibility of clinical response assessment. In this context, we aimed to: (1) critically review the use of advanced positron emission tomography (PET) and magnetic resonance imaging (MRI) in the setting of
PCNSL; (2) provide results from an international survey of clinical sites describing the current practices for routine and advanced imaging, and (3) provide biologically based recommendations from the International
PCNSL Collaborative Group (IPCG) on adaptation of standardized imaging practices. The IPCG provides PET and MRI
consensus recommendations built upon previous recommendations for standardized brain tumor imaging protocols (BTIP) in primary and metastatic disease. A biologically integrated approach is provided to addresses the unique challenges associated with the imaging assessment of PCNSL. Detailed imaging parameters facilitate the adoption of these recommendations by researchers and clinicians. To enhance clinical feasibility, we have developed both \"ideal\" and \"minimum standard\" protocols at 3T and 1.5T MR systems that will facilitate widespread adoption.