PMC5317063_01
(a) MRI image shows focal nodular enhancement and thickening on cerebellar follia (arrows). Transaxial (b) and sagittal (c) images of PET, and transaxial PET/CT fusion images obtained 60 min after an intravenous injection of 370 MBq of 18F-FDG shows increased focal FDG accumulation on the surface of both cerebellar and cerebral hemispheres (arrows). F-18 FDG PET/CT: F-18 fluorodeoxyglucose positron emission tomography/computerized tomography, MRI: Magnetic resonance imaging
IJNM-32-16-g001.jpg
PMC5317063_01_IJNM-32-16-g001.jpg
F1
The contrast-enhanced brain MRI was performed, and it revealed that abnormal hyperintense signal and nodular thickness on the surface of the bilateral cerebral and cerebellar hemispheres, suggestive of LC [Figure 1a]. PET/computerized tomography (CT) study to identify if there were any other metastases. PET/CT images showed increased abnormal FDG accumulations on both cerebellar and cerebral hemispheres surfaces with highly suspicious for LC [Figure 1b and c]; multiple bone metastases involving vertebral column, sternum, iliac bones were also shown.
PMC5317063_02
(a) Contrast axial images of MRI showing dural thickness and nodularities with contrast fixation of right and left cerebral leptomeninges (arrows). Transaxial (b) Transaxial images of 18F - FDG PET showing increases lepromeningeal FDG uptake on the right and left cerebral hemisphers (arrows)
IJNM-32-16-g002.jpg
PMC5317063_02_IJNM-32-16-g002.jpg
F2
Whole body F-18 FDG PET showed bone metastases; additionally increased focal FDG accumulations on the right and left cerebral surface area which was highly suspicious for dural metastases [Figure 2b]. Contrast-enhanced MRI was requested, in which dural heterogen density and focal nodularity with increase contrast fixation suggestive of LC [Figure 2a].
PMC5317063_03
(a) MRI showing leptomeningeal opacification on posterior cranial fossa, convexite, bilateral temporal lobes surface and intraparencyhmal mass on left frontobazal. Axial (b) slice of PET/CT and axial fusion image (c) demonstrating abnormal FDG uptake on the both surfaces of the cerebellar hemispheres, left temporal lobe, and intraparancymeal mass. F-18 FDG PET/CT: F-18 fluorodeoxyglucose positron emission tomography/computerized tomography, MRI: Magnetic resonance imaging
IJNM-32-16-g003.jpg
PMC5317063_03_IJNM-32-16-g003.jpg
F3
Cranial MRI demonstrated contrast-enhancement on posterior fossa, bilaterally base of temporal lobes suggesting leptomeningeal metastases and 20 cm x 38 cm mass at left temporal lobe [Figure 3a]. PET/CT for investigation of the primary tumor. PET/CT demonstrated increased FDG uptake on the surface of left temporal lobe, both cerebral hemispheres; also a hypermetabolic mass on lower quadrant of left breast [Figure 3b and c].