BACKGROUND: An early diagnosis of meningitis is important to improve patients' survival. Data about a direct comparison of cerebrospinal fluid cytology (CSF-cytology) and MRI are very limited. Therefore, the aim of this study was to compare these two diagnostic modalities in diagnosing meningitis in patients with hematopoietic and solid malignancies. METHODS: In 68 patients suspicious for neoplastic meningitis, cytology and MRI (1.5 T) was performed. The meningeal, pial or intraparenchymal hyperintense signal or contrast enhancement was correlated to the final CNS diagnosis and to cytology. RESULTS: 44 patients (64.7%) had neoplastic meningitis, 21 patients (30.9%) had non-neoplastic meningitis. The sensitivity to diagnose meningeal disease was 49.2% for MRI and 95.4% for cytology (p<0.001). In patients with neoplastic meningitis, sensitivity was 45.5% for MRI and 93.2% for cytology (p<0.001). In patients with infectious meningitis, sensitivity was 57.1% for MRI and 100% for cytology (p=0.0013). In patients with solid tumors, the sensitivity was 84.6% for both diagnostic methods. The sensitivity for MRI was low in patients with leukemia (20.0%) and lymphoma (37.5%). The positive predictive value (PPV) for MRI to differentiate infectious from neoplastic meningitis was high in patients with infectious meningitis (75.0%), in patients with lymphoma (83.3%), and in patients with solid tumors (72.7%). Ppv was low in patients with leukemia (33.3%). CONCLUSION: Diagnostic value of MRI for diagnosing meningitis is especially limited in patients with hematopoietic malignancies. MRI better detected leptomeningeal involvement caused by solid tumors than by leukemia or lymphoma. The ppv to specify neoplastic meningitis depends on tumor subtype.
BACKGROUND: An early diagnosis of meningitis is important to improve patients' survival. Data about a direct comparison of cerebrospinal fluid cytology (CSF-cytology) and MRI are very limited. Therefore, the aim of this study was to compare these two diagnostic modalities in diagnosing meningitis in patients with hematopoietic and solid malignancies. METHODS: In 68 patients suspicious for neoplastic meningitis, cytology and MRI (1.5 T) was performed. The meningeal, pial or intraparenchymal hyperintense signal or contrast enhancement was correlated to the final CNS diagnosis and to cytology. RESULTS: 44 patients (64.7%) had neoplastic meningitis, 21 patients (30.9%) had non-neoplastic meningitis. The sensitivity to diagnose meningeal disease was 49.2% for MRI and 95.4% for cytology (p<0.001). In patients with neoplastic meningitis, sensitivity was 45.5% for MRI and 93.2% for cytology (p<0.001). In patients with infectious meningitis, sensitivity was 57.1% for MRI and 100% for cytology (p=0.0013). In patients with solid tumors, the sensitivity was 84.6% for both diagnostic methods. The sensitivity for MRI was low in patients with leukemia (20.0%) and lymphoma (37.5%). The positive predictive value (PPV) for MRI to differentiate infectious from neoplastic meningitis was high in patients with infectious meningitis (75.0%), in patients with lymphoma (83.3%), and in patients with solid tumors (72.7%). Ppv was low in patients with leukemia (33.3%). CONCLUSION: Diagnostic value of MRI for diagnosing meningitis is especially limited in patients with hematopoietic malignancies. MRI better detected leptomeningeal involvement caused by solid tumors than by leukemia or lymphoma. The ppv to specify neoplastic meningitis depends on tumor subtype.
Authors: Marc Chamberlain; Riccardo Soffietti; Jeffrey Raizer; Roberta Rudà; Dieta Brandsma; Willem Boogerd; Sophie Taillibert; Morris D Groves; Emilie Le Rhun; Larry Junck; Martin van den Bent; Patrick Y Wen; Kurt A Jaeckle Journal: Neuro Oncol Date: 2014-05-27 Impact factor: 12.300
Authors: Francisco-Javier Peñalver; Juan-Manuel Sancho; Adolfo de la Fuente; María-Teresa Olave; Alejandro Martín; Carlos Panizo; Elena Pérez; Antonio Salar; Alberto Orfao Journal: Haematologica Date: 2016-10-20 Impact factor: 9.941
Authors: Marc Chamberlain; Larry Junck; Dieta Brandsma; Riccardo Soffietti; Roberta Rudà; Jeffrey Raizer; Willem Boogerd; Sophie Taillibert; Morris D Groves; Emilie Le Rhun; Julie Walker; Martin van den Bent; Patrick Y Wen; Kurt A Jaeckle Journal: Neuro Oncol Date: 2017-04-01 Impact factor: 12.300
Authors: Jennie W Taylor; Eoin P Flanagan; Brian P O'Neill; Tali Siegal; Antonio Omuro; Lisa Deangelis; Joachim Baehring; Ryo Nishikawa; Fernando Pinto; Marc Chamberlain; Khe Hoang-Xuan; Alberto Gonzalez-Aguilar; Tracy Batchelor; Jean-Yves Blay; Agnieszka Korfel; Rebecca A Betensky; Maria-Beatriz S Lopes; David Schiff Journal: Neurology Date: 2013-10-09 Impact factor: 9.910
Authors: Xuling Lin; Martin Fleisher; Marc Rosenblum; Oscar Lin; Adrienne Boire; Samuel Briggs; Yevgeniya Bensman; Brenda Hurtado; Larisa Shagabayeva; Lisa M DeAngelis; Katherine S Panageas; Antonio Omuro; Elena I Pentsova Journal: Neuro Oncol Date: 2017-09-01 Impact factor: 12.300