title: 18F-fluoroethyl-L-tyrosine positron emission tomography for the differential diagnosis of tumefactive multiple sclerosis versus glioma: A case report.
abstract: Large demyelinating inflammatory central nervous system (CNS) lesions may present with contrast enhancement on magnetic resonance imaging and may mimic CNS tumors such as glioma. In ambiguous cases, new diagnostic tools that may be helpful for distinguishing between demyelinating inflammatory and neoplastic CNS lesions are required. The current study presents the case of a patient with a large contrast-enhanced frontal brain lesion, who was initially diagnosed with tumefactive multiple sclerosis. Following the progression of the brain lesion, an18F-fluoroethyl-L-tyrosine positron emission tomography (18F-FET PET) was performed, revealing markedly elevated static18F-FET uptake parameters along with time activity-curves consistent with glioma. Subsequently, a biopsy was undertaken, which confirmed the presence of anaplastic oligoastrocytoma. This case illustrates that18F-FET PET may provide useful diagnostic information in cases where distinction between neoplastic and demyelinating inflammatory CNS lesions is challenging. However, further systematic and prospective analyses are warranted to explore the value of this method in this setting.
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn 53127, Germany; Stem Cell Pathologies Group, Institute of Reconstructive Neurobiology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Sied
authors.initials: S
authors.lastname: Kebir
authors.affiliation: Department of Nuclear Medicine, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Florian C
authors.initials: FC
authors.lastname: Gaertner
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Mueller
authors.affiliation: Department of Radiology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Nelles
authors.affiliation: Department of Neurosurgery, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Simon
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn 53127, Germany; Stem Cell Pathologies Group, Institute of Reconstructive Neurobiology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Schäfer
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Moritz
authors.initials: M
authors.lastname: Stuplich
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Schaub
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Niessen
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Frederic
authors.initials: F
authors.lastname: Mack
authors.affiliation: Department of Nuclear Medicine, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Ralph
authors.initials: R
authors.lastname: Bundschuh
authors.affiliation: Department of Radiology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Greschus
authors.affiliation: Department of Nuclear Medicine, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Essler
authors.affiliation: Stem Cell Pathologies Group, Institute of Reconstructive Neurobiology, University of Bonn Medical Center, Bonn 53127, Germany; Clinical Cooperation Unit Neurooncology, MediClin Robert Janker Klinik, Bonn 53129, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Glas
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn 53127, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Herrlinger
keywords: 18F-fluoroethyl-L-tyrosine positron emission tomography; dynamic 18F-FET PET; glioma; static 18F-FET PET; tumefactive multiple sclerosis