Consensus recommendations for MRI and PET imaging of primary central nervous system lymphoma: guideline statement from the International Primary CNS Lymphoma Collaborative Group (IPCG)

Author:

Barajas Ramon F123ORCID,Politi Letterio S45ORCID,Anzalone Nicoletta6ORCID,Schöder Heiko7ORCID,Fox Christopher P8,Boxerman Jerrold L9,Kaufmann Timothy J10,Quarles C Chad11,Ellingson Benjamin M1213ORCID,Auer Dorothee141516,Andronesi Ovidiu C17,Ferreri Andres J M18,Mrugala Maciej M1920,Grommes Christian2122,Neuwelt Edward A23242526,Ambady Prakash2324,Rubenstein James L272829,Illerhaus Gerald30,Nagane Motoo31ORCID,Batchelor Tracy T32,Hu Leland S33

Affiliation:

1. Department of Radiology, Neuroradiology Section, Oregon Health & Science University, Portland Oregon, USA

2. Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA

3. Knight Cancer Institute Translational Oncology Program, Oregon Health & Science University, Portland, Oregon, USA

4. Humanitas University and Humanitas Research and Clinical Center - IRCCS, Milan, Italy

5. Boston Children’s Hospital, Boston, Massachusetts, USA

6. Neuroradiology Unit, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy

7. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

8. Department of Clinical Haematology, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham, UK

9. Department of Diagnostic Imaging, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA

10. Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA

11. Department of Neuroimaging Research & Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA

12. UCLA Brain Tumor Imaging Laboratory (BTIL), Departments of Radiological Sciences and Psychiatry, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, California, USA

13. Departments of Radiological Sciences, Psychiatry, and Biobehavioral Sciences, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, California, USA

14. Versus Arthritis Pain Centre, University of Nottingham, Nottingham, UK

15. NIHR Nottingham Biomedical Research Centre, Queen’s Medical Centre, University of Nottingham, Nottingham, UK

16. Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK

17. A. A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts, USA

18. Lymphoma Unit, Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy

19. Department of Medicine, Division of Hematology and Oncology, Mayo Clinic Cancer Center, Phoenix, Arizona, USA

20. Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA

21. Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA

22. Department of Neurology, Weill Cornell Medical School, New York, New York, USA

23. Blood-Brain Barrier Program, Oregon Health & Science University, Portland, Oregon, USA

24. Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA

25. Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA

26. Portland Veterans Affairs Medical Center, Portland, Oregon, USA

27. Division of Hematology/Oncology, University of California, San Francisco, California, USA

28. Department of Medicine, University of California, San Francisco, California, USA

29. Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA

30. Clinic of Hematology, Oncology and Palliative Care, Klinikum Stuttgart, Stuttgart, Germany

31. Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan

32. Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

33. Department of Radiology, Neuroradiology Division, Mayo Clinic, Phoenix, Arizona, USA

Abstract

Abstract 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.

Funder

National Institutes of Health

National Cancer Institute

American Cancer Society

National Institute of Neurological Disorders and Stroke

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Clinical Neurology,Oncology

Reference52 articles.

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