Imaging Findings of 18 F-Choline and 18 F-DOPA PET/MRI in a Case of Glioblastoma Multiforme Pseudoprogression: Correlation with Clinical Outcome.
Luca FilippiAngela SpanuOreste BagniOrazio SchillaciBarbara PalumboPublished in: Nuclear medicine and molecular imaging (2022)
We describe the case of 74-year-old-male, previously treated with fronto-parietal craniotomy due to primary glioblastoma multiforme (GBM), followed by concurrent radiation therapy (RT) and temozolomide (TMZ) chemotherapy. Magnetic resonance imaging (MRI) of the brain, at 1 month after completing RT + TMZ, depicted partial response. Three months later, the patient was submitted to a further brain MRI, that resulted doubtful for therapy induced changes (i.e., pseudoprogression). The patient, who had been previously treated with prostatectomy for prostate cancer (PC), underwent a positron emission tomography/computed tomography (PET/CT) scan with 18 F-choline for PC biochemical recurrence. 18 F-choline whole body PET/CT resulted negative for PC relapse, while segmental brain PET, co-registered with MRI, demonstrated increased tracer uptake corresponding to tumor boundaries. In order to solve differential diagnosis between pseudoprogression and GBM recurrence, brain PET/CT with 18 F-L-dihydroxy-phenil-alanine ( 18 F-DOPA) was subsequently performed: fused axial PET/MRI images showed increased 18 F-DOPA incorporation in the peri-tumoral edema, but not in tumor boundaries, consistent with the suspicion of GBM pseudoprogression, as then confirmed by clinical and radiological follow-up.
Keyphrases
- pet ct
- positron emission tomography
- computed tomography
- magnetic resonance imaging
- contrast enhanced
- prostate cancer
- diffusion weighted imaging
- resting state
- radiation therapy
- white matter
- pet imaging
- case report
- optical coherence tomography
- squamous cell carcinoma
- high resolution
- free survival
- working memory
- deep learning
- machine learning
- stem cells
- oxidative stress
- endothelial cells
- radiation induced