FDG-PET to predict different patterns of progression in multicentric glioblastoma: a case report.
True multicentric glioblastoma multiforme (GBM) is rare and consists of separate distinct tumors in different cerebral lobes or hemispheres without any apparent route of dissemination. Few data are available describing its imaging using positron emission tomography (PET) with [18F]-fluoro-2-deoxy-D: -glucose (FDG). In this paper, we report on the case of a man with bifocal tumor in the right frontal and temporal lobes who underwent FDG-PET imaging. Visual and semiquantitative analysis showed two different metabolic patterns with much more intense uptake in the smaller temporal lesion. Subtotal surgical removal of the main frontal lesion allowed satisfactory control in the operative site, whereas the temporal lesion was rapidly progressive with occurrence of necrosis, which led to a second neurosurgery. The diagnosis of glioblastoma was confirmed by neuropathological examination in both cases but with much higher immunohistochemical expression of O(6)-methylguanine-DNA-methyltransferase (MGMT) in the temporal lesion. This report illustrates the potential interest of FDG-PET in multicentric GBMs to identify different metabolic patterns, in accordance with clinical, morphological, and molecular aggressiveness.
Department of Nuclear Medicine, Centre Hospitalo-Universitaire de la Timone (CHU Timone), 264 Rue Saint-Pierre, 13385, Marseille Cedex 5, France. cecile.colavolpe@ap-hm.fr
Cécile
C
Colavolpe
Eric
E
Guedj
Philippe
P
Metellus
Maryline
M
Barrie
Dominique
D
Figarella-Branger
Olivier
O
Mundler
Olivier
O
Chinot
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D018450:Disease Progression; D019788:Fluorodeoxyglucose F18; D005909:Glioblastoma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D049268:Positron-Emission Tomography
D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18