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18 F-DOPA PET Silence in High-grade Glioma Subtype F : A Distinct Metabolic Phenotype
Chloé Quéré1, Franck Bielle2,3, Alberto Picca3,4
1Departments of Nuclear Medicine.
Abstract:
The 2021 WHO classification distinguishes adult-type diffuse gliomas as astrocytoma, oligodendroglioma, and glioblastoma. Recently, a new epigenetic subtype-high-grade glioma IDH-wildtype, subtype F (HGG-F)-has been described, characterized by gliomatosis-like infiltration, low proliferative index, and unexpectedly prolonged survival despite a grade 4 methylation profile. We report the first HGG-F evaluated with 18 F-DOPA PET. Despite extensive FLAIR-hyperintense lesions, tracer distribution was entirely normal. This "amino acid PET silence," contrasting with the typically intense uptake in high-grade gliomas, together with the gliomatosis-like MRI appearance, should raise suspicion for this emerging subtype.
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