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A 73-year-old male patient presented with a generalized tonic-clonic seizure at the emergency department. On the CT, an intracranial mass was found in the left parietal lobe with perifocal edema and pin-shaped calcifications. The MRI revealed a hypointense mass with subtle contrast enhancement only, leading to the suspicion of an oligodendroglioma. A dynamic [18F]FET PET scan was performed additionally which showed an intense [18F]FET uptake of the lesion and decreasing time–activity curves after an early peak uptake at 7 min after tracer injection. The PET parameters were highly suspicious for an aggressive brain tumor, and the subsequent stereotactic biopsy did indeed reveal an IDH wild-type glioblastoma. Dynamic [18F]FET PET can help to identify aggressive tumor tissue even if conventional imaging suggests a lower grade glioma.

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Case 40: Primary Diagnosis of a Glioblastoma with Atypical Presentation on MRI

  • 章节

  • 发表日期：

    2025年

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  • Nathalie L. Albert,
  • Bogdana Suchorska,
  • Adrien Holzgreve,
  • Marcus Unterrainer

摘要

A 73-year-old male patient presented with a generalized tonic-clonic seizure at the emergency department. On the CT, an intracranial mass was found in the left parietal lobe with perifocal edema and pin-shaped calcifications. The MRI revealed a hypointense mass with subtle contrast enhancement only, leading to the suspicion of an oligodendroglioma. A dynamic [18F]FET PET scan was performed additionally which showed an intense [18F]FET uptake of the lesion and decreasing time–activity curves after an early peak uptake at 7 min after tracer injection. The PET parameters were highly suspicious for an aggressive brain tumor, and the subsequent stereotactic biopsy did indeed reveal an IDH wild-type glioblastoma. Dynamic [18F]FET PET can help to identify aggressive tumor tissue even if conventional imaging suggests a lower grade glioma.