Increased Vertebral Gallium-68-DOTATATE Activity on Positron Emission Tomography-Computed Tomography in Merkel Cell Carcinoma: Not Always Metastasis.

Merkel cell carcinoma (MCC) is a rare neuroendocrine dermal malignancy seen in elderly light-skinned individuals, associated with immunosuppression and Merkel cell polyomavirus infection. As a neuroendocrine tumor, the recurrence and metastasis of MCC can be evaluated using positron emission tomography-computed tomography (PET-CT) with the Gallium-68-DOTATATE (Ga-68-DOTATATE) radiotracer, which has demonstrated increased sensitivity to neuroendocrine metastases when compared to F-18 fluorodeoxyglucose (FDG). Here, we present the case of a patient with known metastatic MCC with a new, abnormal focus of increased radiotracer activity in the thoracic spine on Ga-68-DOTATATE PET-CT suspected to represent a metastatic lesion.

MRI features associated with rapid disease activity in clinically isolated syndrome patients at high risk for multiple sclerosis.

Clinically isolated syndrome (CIS) is a central nervous system inflammatory and demyelinating event that lasts at least 24 h and can represent the first episode of relapsing-remitting multiple sclerosis. MRI is an important imaging tool in the diagnosis and longitudinal monitoring of CIS progression. Accurate differential diagnosis of high-risk versus low-risk CIS is important because high-risk CIS patients could be treated early.

MRI features associated with high likelihood of conversion of radiologically isolated syndrome to multiple sclerosis.

Radiologically isolated syndrome (RIS) is the asymptomatic precursor to clinically isolated syndrome, relapsing-remitting multiple sclerosis (MS) or primary progressive MS. RIS is frequently diagnosed when an individual gets an MRI for an unrelated medical issue, such as headache or trauma. Treating RIS patients is controversial, but physicians may be inclined to offer prophylactic treatment for high-risk RIS patients.

Ectopic craniopharyngioma of the fourth ventricle in a patient with Gardner syndrome.

Ectopic craniopharyngioma is uncommon and a craniopharyngioma confined purely within the fourth ventricle is extremely rare. We report a craniopharyngioma of the fourth ventricle in a 20-year-old man with Gardner syndrome. Imaging characteristics of craniopharyngiomas and fourth ventricle lesions are discussed with a review of the literature regarding the pathogenesis of craniopharyngiomas and the possible association with Gardner syndrome.

Report from a quality assurance program on patients undergoing the MILD procedure.

Objectives: To characterize trends in pain and functional outcomes and identify risk factors in patients with lumbar spinal stenosis (LSS) and neurogenic claudication undergoing the "Minimally Invasive Lumbar Decompression" (MILD) procedure.

Design: Retrospective observational cohort study.

Setting: Academic multidisciplinary pain center at Stony Brook Medicine.

Reversible pituitary hyperplasia at birth in a macrosomic full-term baby boy.

Pituitary hyperplasia is generally associated with end-organ failure such as primary hypothyroidism, physiological changes such as puberty and pregnancy, or neoplasms secreting releasing factors. We present a full-term infant with an enlarged pituitary height of 8 mm at age 3 days despite a normal endocrinological evaluation. Repeat imaging at 5 months of age revealed a normal-size pituitary gland.

High-dose cyclophosphamide for moderate to severe refractory multiple sclerosis: 2-year follow-up (investigational new drug No. 65863).

High-dose cyclophosphamide (HDC) is a chemotherapy treatment designed to eradicate autoreative B- and T-cells responsible for lymphocyte-mediated autoimmune illness while sparing the pluripotent blood stem cell of any ill effects. Multiple sclerosis (MS) is the most common inflammatory and demyelinating immune-mediated disorder of the central nervous system in young adults. Patients with moderate to severe, refractory MS, defined as an Expanded Disability Status Scale (EDSS) score of 3.

Parietal lobe epileptic focus identified on SPECT-MRI fusion imaging in a case of epilepsia partialis continua.

Epilepsia partialis continua, or "Kozhevnikov syndrome," is a rare condition characterized by persistent localized motor seizures usually localized in a distant limb. It is most often seen in children under 16 years old without gender preference. We report a 12-year-old girl with epilepsia partialis continua who presented to the emergency room after the onset of seizures.

High-dose cyclophosphamide for moderate to severe refractory multiple sclerosis.

Background: High-dose cyclophosphamide is active in immune-mediated illnesses.

Objective: To describe the effects of high-dose cyclophosphamide on severe refractory multiple sclerosis.

Design, Setting, And Patients: Patients with multiple sclerosis with an Expanded Disability Status Scale (EDSS) score of 3.

Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients.

Objective: To relate neuropsychological performance to measures of cerebral injury in persons with MS selected for cognitive impairment.

Methods: Participants were 37 individuals with relapsing-remitting (59.5%) and secondary progressive (40.

The potential for vigabatrin-induced intramyelinic edema in humans.

Purpose: Vigabatrin (Sabril, Hoechst Marion Roussel) is an antiepilepsy drug (AED) presently marketed in 64 countries for the treatment of partial and secondarily generalized seizures. Vigabatrin (VGB) is marketed in a subset of these countries for the treatment of infantile spasms. Clinical experience in humans has shown that VGB provides effective seizure control with a wide margin of safety.

Use of ex vivo magnetic resonance imaging to detect onset of vigabatrin-induced intramyelinic edema in canine brain.

Vigabatrin (VGB) causes intramyelinic edema (microvacuolation) in brain of dogs and rodent, which has encouraged development of noninvasive methods to monitor for this effect during clinical trials. We report the qualitative ex vivo magnetic resonance imaging (MRI) changes observed in a neuropathology study in dogs to detect time of onset and regression of VGB-induced intramyelinic edema. Beagles were randomly assigned to 18 groups of 6 dogs per group and administered vigabatrin orally (p.

Abnormal corpus callosum: a sensitive and specific indicator of multiple sclerosis.

The authors investigated whether identification of corpus callosal (CC) involvement might increase the specificity of magnetic resonance (MR) imaging in differentiating multiple sclerosis (MS) from other periventricular white matter diseases (PWDs). They prospectively evaluated 42 patients with MS and 127 control patients with other PWDs. Ninety-three percent of the MS patients demonstrated confluent and/or focal lesions involving the callosal-septal interface (CSI).

Iodine125 labeled anti-epidermal growth factor receptor-425 in the treatment of malignant astrocytomas. A pilot study.

In 1986, a pilot Phase I/II project was initiated using Iodine-125 labeled anti-epidermal growth factor receptor-425 in the treatment of patients with recurrent glioblastoma multiforme of the brain. The monoclonal antibody was administered intra-arterially by the internal carotid arterial system or the vertebral arterial system depending upon the blood supply to the tumor. The treatment program was repeated at intervals for two or three times.

Intraocular tumors: evaluation with MR imaging.

Sixty-seven ocular tumors were studied with magnetic resonance (MR) imaging and computed tomography (CT). These tumors included primary uveal melanoma (n = 55), circumscribed choroidal hemangioma (n = 3), diffuse choroidal hemangioma (n = 1), retinal capillary hemangioma (n = 1), medulloepithelioma (n = 1), choroidal nevus (n = 1), retinoblastoma (n = 1), and choroidal metastases (n = 4). MR imaging demonstrated all these lesions, while CT demonstrated 88%.

Infrasellar craniopharyngioma: CT and MR studies.

A rare case of an infrasellar craniopharyngioma is reported. Pathological proof and CT and magnetic resonance (MR) images of the tumor are presented. This case is thought to demonstrate the first example of MR images of an infrasellar craniopharyngioma.

Sixth nerve schwannoma: MR and CT demonstration.

A sixth nerve schwannoma arising in the region of the pons and midbrain is reported. The magnetic resonance and CT characteristics are discussed.

CT demonstration of extraocular muscle atrophy.

Two cases of CT-documented extraocular muscle atrophy are presented. Unilateral atrophy was observed in a patient with a lesion of the cavernous sinus. Atrophic extraocular muscles were noted bilaterally in a young woman with "ophthalmoplegia plus" (probable Kearns-Sayre syndrome).

Computed tomography of posterior uveal melanomas.

Computed tomographic (CT) scans were obtained from 48 patients with posterior uveal melanoma. The CT measurements of maximal and minimal basal diameters and thickness of each tumor were compared with the assessments of these tumor dimensions obtained by ophthalmoscopic estimation (basal diameters only) and standardized A-scan ultrasonography (thickness only) and with the gross pathologic measurements of these tumors. The correlation between measurements of tumor thickness by CT scanning, standardized A-scan ultrasonography, and gross pathologic analysis was substantially better than that between the CT, ophthalmoscopic, and gross pathologic measurements of tumor basal diameters.

Orbital metastasis from a carcinoid tumor. Computed tomography, magnetic resonance imaging, and electron microscopic findings.

An otherwise asymptomatic 63-year-old woman with a history of a carcinoid tumor of the ileum and a cutaneous melanoma of the shoulder developed unilateral proptosis. Orbital ultrasonography, computed tomography, and magnetic resonance imaging revealed a large, well-circumscribed orbital mass involving the superior rectus muscle. The surgically excised tumor was studied by light microscopy, histochemistry, and transmission electron microscopy.

Orbital metastasis: role of magnetic resonance imaging and computed tomography.

Imaging of ocular and oral metastasis with CT and MRI is discussed. The relative advantages and disadvantages of the two techniques are presented. MRI seems to be particularly useful in discriminating intraocular tumor from retinal detachment.