ArticleEuropean radiology2021
Progressive multifocal leukoencephalopathy: MRI findings in HIV-infected patients are closer to rituximab- than natalizumab-associated PML.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 19 citations in OpenAlex.
- Multiplanar MRI approach to the differential diagnosis of central nervous system tumors and tumor-like lesions in patients with HIV: what radiologists need to know.Frontiers in medicine · 2026Review
- Cosmic Signs in Radiology: A Pictorial Review.Diagnostics (Basel, Switzerland) · 2025Review
- John Cunningham Virus and Progressive Multifocal Leukoencephalopathy: A Falsely Played Diagnosis.Diseases (Basel, Switzerland) · 2024Review
- Gliomatosis cerebri with blindness: A case report with literature review.Radiology case reports · 2023Article
- Cerebellar Progressive Multifocal Leukoencephalopathy Mimicking Anti-Yo-Antibody-Associated Rapidly Progressive Cerebellar Syndrome.Neurology international · 2023Article
- HIV-associated dementia presenting predominantly with clinical motor deficits: A case report.Radiology case reports · 2022Article
- The neuroradiology of progressive multifocal leukoencephalopathy: a clinical trial perspective.Brain : a journal of neurology · 2022Review
- Progressive multifocal leukoencephalopathy - a diagnostic guide for the clinical neurologist.Frontiers in neurologyReview
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Authors and funding
28 authors at 16 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare brain MRI findings in progressive multifocal leukoencephalopathy (PML) associated to rituximab and natalizumab treatments and HIV infection. MATERIALS AND
methodsIn this retrospective, multicentric study, we analyzed brain MRI exams from 72 patients diagnosed with definite PML: 32 after natalizumab treatment, 20 after rituximab treatment, and 20 HIV patients. We compared T2- or FLAIR-weighted images, diffusion-weighted images, T2*-weighted images, and contrast enhancement features, as well as lesion distribution, especially gray matter involvement.
resultsThe three PML entities affect U-fibers associated with low signal intensities on T2*-weighted sequences. Natalizumab-associated PML showed a punctuate microcystic appearance in or in the vicinity of the main PML lesions, a potential involvement of the cortex, and contrast enhancement. HIV and rituximab-associated PML showed only mild contrast enhancement, punctuate appearance, and cortical involvement. The CD4/CD8 ratio showed a trend to be higher in the natalizumab group, possibly mirroring a more efficient immune response.
conclusionImaging features of rituximab-associated PML are different from those of natalizumab-associated PML and are closer to those observed in HIV-associated PML. KEY POINTS: • Nowadays, PML is emerging as a complication of new effective therapies based on monoclonal antibodies. • Natalizumab-associated PML shows more inflammatory signs, a perivascular distribution "the milky way," and more cortex involvement than rituximab- and HIV-associated PML. • MRI differences are probably related to higher levels of immunosuppression in HIV patients and those under rituximab therapy.
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