1
|
Park SY, Lee MK, Han EJ, Jeon YW. Cerebrovascular Malformation Mimicking Recurrent Lymphoma on Dual Time-Point 18F-FDOPA PET. Clin Nucl Med 2024; 49:232-233. [PMID: 38306374 DOI: 10.1097/rlu.0000000000005023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
ABSTRACT Although 18F-FDG is the dominant radiotracer for PET imaging of hematological malignancies, radiolabeled amino acids have also been investigated to improve image quality in areas of high 18F-FDG uptake such as the central nervous system. We present a case of a 57-year-old woman who underwent an 18F-FDOPA scan for primary CNS lymphoma, which demonstrated an unexpected false-positive uptake in the right frontal lobe, due to a developmental venous anomaly.
Collapse
Affiliation(s)
| | | | - Eun Ji Han
- From the Division of Nuclear Medicine, Department of Radiology
| | - Young-Woo Jeon
- Department of Hematology, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
2
|
Bianconi A, Salvati LF, Perrelli A, Ferraris C, Massara A, Minardi M, Aruta G, Rosso M, Massa Micon B, Garbossa D, Retta SF. Distant Recurrence of a Cerebral Cavernous Malformation in the Vicinity of a Developmental Venous Anomaly: Case Report of Local Oxy-Inflammatory Events. Int J Mol Sci 2022; 23:ijms232314643. [PMID: 36498972 PMCID: PMC9736411 DOI: 10.3390/ijms232314643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cerebral cavernous malformations (CCMs) are a major type of cerebrovascular lesions of proven genetic origin that occur in either sporadic (sCCM) or familial (fCCM) forms, the latter being inherited as an autosomal dominant condition linked to loss-of-function mutations in three known CCM genes. In contrast to fCCMs, sCCMs are rarely linked to mutations in CCM genes and are instead commonly and peculiarly associated with developmental venous anomalies (DVAs), suggesting distinct origins and common pathogenic mechanisms. CASE REPORT A hemorrhagic sCCM in the right frontal lobe of the brain was surgically excised from a symptomatic 3 year old patient, preserving intact and pervious the associated DVA. MRI follow-up examination performed periodically up to 15 years after neurosurgery intervention demonstrated complete removal of the CCM lesion and no residual or relapse signs. However, 18 years after surgery, the patient experienced acute episodes of paresthesia due to a distant recurrence of a new hemorrhagic CCM lesion located within the same area as the previous one. A new surgical intervention was, therefore, necessary, which was again limited to the CCM without affecting the pre-existing DVA. Subsequent follow-up examination by contrast-enhanced MRI evidenced a persistent pattern of signal-intensity abnormalities in the bed of the DVA, including hyperintense gliotic areas, suggesting chronic inflammatory conditions. CONCLUSIONS This case report highlights the possibility of long-term distant recurrence of hemorrhagic sCCMs associated with a DVA, suggesting that such recurrence is secondary to focal sterile inflammatory conditions generated by the DVA.
Collapse
Affiliation(s)
- Andrea Bianconi
- Division of Neurosurgery, Department of Neurosciences “Rita Levi Montalcini”, City of Health and Science and University of Turin, 10124 Torino, Italy
- CCM Italia Research Network, National Coordination Center, Department of Clinical and Biological Sciences, University of Turin, 10124 Orbassano, Italy
- Correspondence: (A.B.); (S.F.R.)
| | | | - Andrea Perrelli
- CCM Italia Research Network, National Coordination Center, Department of Clinical and Biological Sciences, University of Turin, 10124 Orbassano, Italy
- Department of Clinical and Biological Sciences, School of Medicine and Surgery, University of Turin, Regione Gonzole 10, 10124 Orbassano, Italy
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, NY 14602, USA
| | - Chiara Ferraris
- CCM Italia Research Network, National Coordination Center, Department of Clinical and Biological Sciences, University of Turin, 10124 Orbassano, Italy
- Department of Clinical and Biological Sciences, School of Medicine and Surgery, University of Turin, Regione Gonzole 10, 10124 Orbassano, Italy
| | - Armando Massara
- Division of Neurosurgery, Department of Neurosciences “Rita Levi Montalcini”, City of Health and Science and University of Turin, 10124 Torino, Italy
| | - Massimiliano Minardi
- Division of Neurosurgery, Department of Neurosciences “Rita Levi Montalcini”, City of Health and Science and University of Turin, 10124 Torino, Italy
| | - Gelsomina Aruta
- Division of Neurosurgery, Department of Neurosciences “Rita Levi Montalcini”, City of Health and Science and University of Turin, 10124 Torino, Italy
| | - Miriam Rosso
- Division of Neurosurgery, Department of Neurosciences “Rita Levi Montalcini”, City of Health and Science and University of Turin, 10124 Torino, Italy
| | - Barbara Massa Micon
- Division of Neurosurgery, Department of Neurosciences “Rita Levi Montalcini”, City of Health and Science and University of Turin, 10124 Torino, Italy
| | - Diego Garbossa
- Division of Neurosurgery, Department of Neurosciences “Rita Levi Montalcini”, City of Health and Science and University of Turin, 10124 Torino, Italy
- CCM Italia Research Network, National Coordination Center, Department of Clinical and Biological Sciences, University of Turin, 10124 Orbassano, Italy
| | - Saverio Francesco Retta
- CCM Italia Research Network, National Coordination Center, Department of Clinical and Biological Sciences, University of Turin, 10124 Orbassano, Italy
- Department of Clinical and Biological Sciences, School of Medicine and Surgery, University of Turin, Regione Gonzole 10, 10124 Orbassano, Italy
- Correspondence: (A.B.); (S.F.R.)
| |
Collapse
|
3
|
Renard D, Collombier L, Laurent-Chabalier S, Mura T, Le Floch A, Fertit HE, Thouvenot E, Guillamo JS. 18F-FDOPA-PET in pseudotumoral brain lesions. J Neurol 2020; 268:1266-1275. [PMID: 33084938 DOI: 10.1007/s00415-020-10269-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION 3,4-Dihydroxy-6-[18F]-fluoro-L-phenylalanine (FDOPA) positron emission tomography (PET) is sensitive for identifying primary brain tumors. However, increased FDOPA uptake has been reported in pseudotumoral brain lesions. Our aim was to analyse FDOPA-PET in patients with pseudotumoral brain lesions and to compare them with patients with brain tumors. METHODS We retrospectively analysed consecutively recruited patients with suspected primary brain tumor (based on clinical and magnetic resonance imaging findings) referred for FDOPA-PET in our centre between November 2013 and June 2019 (n = 74). FDOPA-PET parameters (maximum and mean lesion standardised uptake values [SUV] and ratios comparing lesion with different background uptake SUV) and thresholds were evaluated to determine which offered optimal discrimination between pseudotumoral and tumoral lesions. RESULTS Overlapping PET values were observed between pseudotumoral (n = 26) and tumoral (n = 48) lesion, particularly for low-grade tumors. Based on receiver operating characteristic (ROC) analyses, the optimal PET parameters to discriminate pseudotumoral from tumoral lesions were SUVmax lesion/basal ganglia, SUVmax lesion/grey matter, SUVmean lesion/grey matter, and SUVmax lesion/mirror area in contralateral hemisphere (all ratios showing area under the curve [AUC] 0.85, 95% CI). The narrowest 95% sensitivity-95% specificity window was observed for SUVmax lesion/basal ganglia ratio, with ratio values of 0.79 and 1.35 corresponding to 95% sensitivity and 95% specificity, respectively. CONCLUSION FDOPA-PET uptake should be interpreted with caution in patients with suspected primary brain tumor, especially in patients showing low or intermediate SUV values and ratios. CLINICAL TRIAL REGISTRATION-URL: https://www.clinicaltrials.gov . Unique identifier: NCT04306484.
Collapse
Affiliation(s)
- Dimitri Renard
- Department of Neurology, CHU Nîmes, University Montpellier, Nîmes, France.
| | - Laurent Collombier
- Department of Nuclear Medicine, CHU Nîmes, University Montpellier, Nîmes, France
| | - Sabine Laurent-Chabalier
- Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, CHU Nîmes, University Montpellier, Nîmes, France
| | - Thibault Mura
- Department of Biostatistics, Clinical Epidemiology, Public Health, and Innovation in Methodology, CHU Nîmes, University Montpellier, Nîmes, France
| | - Anne Le Floch
- Department of Neurology, CHU Nîmes, University Montpellier, Nîmes, France
| | - Hassan El Fertit
- Department of Neurosurgery, CHU Nîmes, University Montpellier, Nîmes, France
| | - Eric Thouvenot
- Department of Neurology, CHU Nîmes, University Montpellier, Nîmes, France.,Institut de Génomique Fonctionnelle, UMR5203, INSERM 1191, University Montpellier, Montpellier, France
| | | |
Collapse
|