{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:50:42Z","timestamp":1791334242975,"version":"4.3.1"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"14","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,10,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>\n                      Contrast-enhanced MRI reflects blood-brain barrier (BBB) disruption rather than tumor biological activity, whereas\n                      <jats:sup>18<\/jats:sup>\n                      F-fluciclovine (\n                      <jats:sup>18<\/jats:sup>\n                      F-FACBC) PET reflects amino acid metabolism independent of BBB integrity. The authors compared regional\n                      <jats:sup>18<\/jats:sup>\n                      F-FACBC uptake with histopathological and molecular findings in a diffuse astrocytoma,\n                      <jats:italic>IDH<\/jats:italic>\n                      -wildtype, not elsewhere classified, with a gliomatosis cerebri (GC)\u2013like infiltrative growth pattern.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      A woman in her 50s presented with headache. MRI revealed a nonenhancing, diffusely infiltrating right parietal white matter lesion.\n                      <jats:sup>18<\/jats:sup>\n                      F-FACBC PET showed focal uptake that guided stereotactic biopsy. Six weeks later, progression caused left uncal herniation requiring emergency decompression, during which PET-negative left temporal tissue was resected. The PET-positive region showed a high Ki-67 index, high-level\n                      <jats:italic>PDGFRA<\/jats:italic>\n                      amplification, and\n                      <jats:italic>CDKN2A\/B<\/jats:italic>\n                      homozygous deletion, with a methylation profile matching pediatric-type diffuse high-grade glioma, RTK1 subclass. The PET-negative region was predominantly gliotic, with only low-level\n                      <jats:italic>PDGFRA<\/jats:italic>\n                      amplification. Thus, uptake marked a more proliferative, molecularly altered component. However, both the fatal mass effect and out-of-field recurrence following chemoradiotherapy occurred in regions without corresponding uptake.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>\n                      <jats:sup>18<\/jats:sup>\n                      F-FACBC PET identified an aggressive, high-risk tumor component, supporting its use for biopsy targeting in nonenhancing gliomas. However, because life-threatening progression occurred without corresponding uptake,\n                      <jats:sup>18<\/jats:sup>\n                      F-FACBC uptake reflects proliferative burden rather than the full infiltrative extent.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE26761\">https:\/\/thejns.org\/doi\/10.3171\/CASE26761<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case26761","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:01:25Z","timestamp":1790726485000},"source":"Crossref","is-referenced-by-count":0,"title":["Utility and limitations of 18F-fluciclovine PET for biopsy targeting in a nonenhancing diffuse glioma with a gliomatosis cerebri\u2013like growth pattern: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"given":"Soma","family":"Matsueda","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayuta","family":"Higa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-4537","authenticated-orcid":true,"given":"Ryutaro","family":"Makino","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8596-3144","authenticated-orcid":true,"given":"Toshiaki","family":"Akahane","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima; and"},{"name":"Center for Human Genome and Gene Analysis, Kagoshima University Hospital, Kagoshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6997-8336","authenticated-orcid":true,"given":"Mari","family":"Kirishima","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Yonezawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihide","family":"Tanimoto","sequence":"additional","affiliation":[{"name":"Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima; and"},{"name":"Center for Human Genome and Gene Analysis, Kagoshima University Hospital, Kagoshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4170-4878","authenticated-orcid":true,"given":"Ryosuke","family":"Hanaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"9","key":"bib1","series-title":"Jpn J Radiol","first-page":"1534","article-title":"Imaging diagnosis of adult-type diffuse gliomas in the era of WHO CNS5 and cIMPACT-NOW updates 8-11: a narrative review","volume":"44","author":"Kurokawa","year":"2026","unstructured":"Kurokawa RTakami HKurokawa MImaging diagnosis of adult-type diffuse gliomas in the era of WHO CNS5 and cIMPACT-NOW updates 8-11: a narrative review. 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