PMC3425229_01
Pretreatment MRI scan with intravenous gadolinium shows a mass in the right lentiform nucleus and internal capsule, with rim enhancement. Wall irregularity is more prominent along the medial aspect
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F1
On admission, MRI scan of the brain [Figure 1] showed a 4 cm rim-enhancing mass in the right cerebrum.
Second post-treatment MRI scan with intravenous gadolinium enhancement shows increased wall thickness, with enhancement. These could represent viable tumor or postradiation therapy inflammation. The first post-treatment MRI scan (not shown) had demonstrated reduction in tumor size and hydrocephalus. An enhancing nodule has developed along the medial wall of the mass. The enhancing area is concordant with the PET scans [Figures 3-5]
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F2
However the patient's headache worsened after another 5 months and a second post-treatment MRI scan was performed [Figure 2].
PET/CT with 18FDG shows diffuse physiologic uptake in the normal brain cortex, and abnormal uptake in the wall of the right basal ganglia mass, especially along the medial aspect
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F3
18Fluorine-fluorodeoxyglucose (FDG) PET/CT and 18fluorine-fluorocholine (FCH) PET/CT were performed [Figures 3 and 4], both showing uptake of tracer around the mass and central photopenia.
PET/CT with 18FCH shows selectively increased uptake in the wall of the mass, more prominent along the medial aspect. Normal brain parenchyma does not show uptake. Slight physiological uptake is seen in the choroid plexus
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F4
18Fluorine-fluorodeoxyglucose (FDG) PET/CT and 18fluorine-fluorocholine (FCH) PET/CT were performed [Figures 3 and 4], both showing uptake of tracer around the mass and central photopenia.
PET/CT with 99Tc-MIBI shows similar distribution of uptake to 18FCH, without uptake by normal brain parenchyma. Physiological uptake by the choroid plexus is more prominent
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F5