Combining MRI with Specific Biomarkers Strengths CNS Lymphoma Diagnosis

Combining MRI with Specific Biomarkers Strengths CNS Lymphoma Diagnosis

In a recent study entitled “The Combined Performance of ADC, CSF CXC Chemokine Ligand 13, and CSF Interleukin 10 in the Diagnosis of Central Nervous System Lymphoma” authors report that decreased MRI apparent diffusion coefficient with increased values of both cerebrospinal fluid CXCL-13 and IL-10 are a marker for central nervous system lymphoma. The study was published in the journal American Journal of Neuroradiology.

Lymphoma is a disease where cancer cells form in the lymphatic system. These cells called lymphocytes travel through the central nervous system (CNS), and upon malignant transformation they trigger CNS lymphoma. When the lymphoma arises within and is restricted to the nervous system it is called primary CNS lymphoma, while a secondary lymphoma is one that has spread to the CNS from elsewhere in the body.

CNS lymphomas are usually diagnosed by MRI, however, a definite diagnosis with MRI is difficult since a patient with a brain mass lesion detected by MRI overlaps with other CNS diseases.

In this study, authors determined whether two molecules produced by lymphocytes in CNS lymphoma, which are detected in the cerebrospinal fluid, could function as cerebrospinal fluid biomarkers for the diagnosis of CNS lymphoma. These molecules include CXC chemokine ligand 13 (CXCL-13), a mediator for immune cells (B cells) migration and interleukin 10 (IL-10), an anti-inflammatory cytokine. This information would be complementary to the MRI findings in terms of brain lesions for the diagnosis of CNS lymphoma.

To test their hypothesis, authors enrolled eighty-seven patients 43 of which presented central nervous system (CNS) lymphoma and 44 did not have CNS lymphoma. All of the patients were previously subjected to a protein analysis of their cerebrospinal fluid and presented a new brain mass on brain MR imaging. The team found that combining the information of MRI analysis (specifically, they measured apparent diffusion coefficient, ADC, a parameter that provides information regarding tissue integrity) with cerebrospinal fluid CXCL-13 and cerebrospinal fluid IL-10 levels significantly increased the accuracy of CNS lymphoma diagnosis.

The findings confirmed previous observations that shwoed decreased ADC values and increased values of both and CSF CXCL-13 and IL-10 could be used as markers for CNS lymphoma. As such, all three variables should be considered in clinical practice when diagnosing CNS lymphoma.

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