Late Persistent Increased Putaminal 18F-DOPA Uptake Following Ipsilateral Frontal Resection: Evidence for Corticostriatal Synaptic Plasticity?

We report the finding of late persistent increased putaminal 18F-3, 4-dihydroxyphenylalanine (DORA) uptake following resection of a high-grade glioma involving the lateral portion of the ipsilateral precentrai gyrus. Brain MRI findings were consistent with secondary putaminal degeneration. This 18F-DOPA PET phenomenon possibly represents elevated presynaptic dopamine function secondary to upregulation of the amino acid decarboxylase (AADC) activity, as a compensatory mechanism in response to cortical injury. In the setting of brain tumor surveillance, focal increased striatal 18F-DOPA uptake should be carefully interpreted in light of MRI findings and pathological changes related to corticostriatal connections.