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Discrepancies of 11C-MET Uptake and MRI Contrast Enhancement in a Glioblastoma: A PET/MRI Case Report

A 58-year-old female patient suffered from convulsion in the left upper limb and weakness in the left lower extremity for one month. In MR contrast-enhancing (CE) images, obvious rim-enhancement was only found in the frontal nodule, while fused 11C-MET PET/MRI images showed increased MET uptake not only in the right frontal lesion but also in the body of corpus callosum. We postulated the discrepancy between MRI CE and MET uptake for the corpus callosum lesion maybe due to the following two reasons: firstly, a relative low malignant potential where absent of BBB disruption; secondly, the special affinity of MET to the oligodendroglioma. In addition, the 1H-MRS, TDI and ASL data acquired simultaneously with PET scan indicated the frontal lesion had the features of typical malignant intracranial tumor. Finally, the pathological results confirmed the frontal lesion a WHO-IV grade glioblastoma with partial anaplasia oligodendroglioma. The imaging follow-up showed a newly abnormal CE in the body of corpus callosum, which was consistent with the previous increased MET uptake on PET/MRI examination. Our case indicates that one-stop multiparametric MET-PET/MRI has advantages for the management of intracranial tumor lesions by providing complementary information.

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