Albert J.S. Idema1, Joyce Wilbers2, P. Krooshof3, A. C. Koetsveld1, P. Wesseling4, W. van der Graaf5, A. Gijtenbeek2, W. Oyen6, A. Heerschap7
1Neurosurgery, UMC St Radboud, Nijmegen, Gelderland, Netherlands; 2Neurology, UMC St Radboud, Netherlands; 3Analytical Chemistry, Institute for Molecules and Materials, Nijmegen, Netherlands; 4Pathology, UMC St Radboud, CWZ, Netherlands; 5Medical Oncology, UMC St Radboud, Netherlands; 6Nuclear Medicine, UMC St Radboud, Netherlands; 7Radiology, UMC St Radboud, Netherlands
In this case report we describe multimodality imaging of neuroschistosomiasis. Besides conventional MRI, this patient was examined with perfusion imaging, short-echo time 3D MR Spectroscopy and 18F-Fluorothymidine PET imaging. The histopathological findings in a biopsy were used to explain the imaging results. An increased FLT activity and lactate, next to a strong NAA decrease may point to a malignant process, however, the minimal increased Choline and perfusion indicate otherwise. Increased levels of glutathione and aspartate may be typical for this lesion. FLT-PET seems not be able to discriminate between active proliferating inflammatory cells and proliferating tumor cells in the brain.
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