Heiss W D, Wienhard K, Wagner R, Lanfermann H, Thiel A, Herholz K, Pietrzyk U
Max Planck Institute for Neurology, Köln, Germany.
J Nucl Med. 1996 Jul;37(7):1180-2.
A 57-yr-old woman suffering from light movement disorder of the left arm and hand was referred for 18F-Dopa PET. The PET study not only proved asymmetrically reduced dopamine uptake in the putamen (influx constant Ki right 0.0064/min, left 0.0086) but also revealed pathologically increased 18F-Dopa accumulation in the right frontal lobe. Further PET examinations demonstrated increased 11C-methionine uptake and low glucose metabolism in this right frontal region. MRI and 1H-MRSI showed a heterogeneous lesion with reduced N-acetyl-aspartate and increased choline and lactate, suggesting a mixed, low-grade glioma. In 15O-water studies, during intentional movements of one hand the respective motor areas were identified, indicating asymmetries due to the mass occupying lesion. The tumor could be removed in open surgery, thus sparing the motor areas; a mild postoperative motor deficit resolved to the presurgical state. Histology confirmed the diagnosis of a grade 2 oligo-astrocytoma. This case impressively demonstrates that 18F-Dopa can be used as an amino acid tracer for brain tumor detection in addition to its established application to assess aromatic acid decarboxylase activity.
一名57岁女性，因左臂和手部轻度运动障碍接受18F-多巴PET检查。PET研究不仅证实壳核多巴胺摄取不对称减少（流入常数Ki：右侧0.0064/min，左侧0.0086），还显示右侧额叶18F-多巴病理性积聚增加。进一步的PET检查显示该右侧额叶区域11C-蛋氨酸摄取增加，葡萄糖代谢降低。MRI和1H-MRSI显示一个异质性病变，N-乙酰天门冬氨酸减少，胆碱和乳酸增加，提示为混合性低级胶质瘤。在15O-水研究中，在单手有意运动期间确定了相应的运动区域，表明由于占位性病变存在不对称性。肿瘤可通过开颅手术切除，从而保留运动区域；术后轻度运动功能障碍恢复到术前状态。组织学确诊为2级少突-星形细胞瘤。该病例令人印象深刻地表明，18F-多巴除了已确立的用于评估芳香酸脱羧酶活性的应用外，还可作为一种氨基酸示踪剂用于脑肿瘤检测。
