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F-Dopa as an Amino Acid Tracer to Detect Brain Tumors

Max Planck Institute for Neurology
Department of Neurology, University of Köln, Köln, Germany

Correspondence: For correspondence or reprints contact W.-D. Heiss, MD, Max Planck Institute for Neurology, Gleueler Str. 50, D-50931 Köln, Germany.

ABSTRACT

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 puts men (influx constant K₁ 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.

Key Words: PET • fluorine-18-Dopa • carbon-11-methionine • fluorodeoxyglucose • oxygen-15-water brain tumor • Parkinson's disease • magnetic resonance spectroscopy

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