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@ARTICLE{Galldiks:173156,
      author       = {Galldiks, Norbert and Dunkl, Veronika and Stoffels,
                      Gabriele and Hutterer, Markus and Rapp, Marion and Sabel,
                      Michael and Reifenberger, Guido and Kebir, Sied and Dorn,
                      Franziska and Blau, Tobias and Herrlinger, Ulrich and Hau,
                      Peter and Ruge, Maximilian I. and Kocher, Martin and
                      Goldbrunner, Roland and Fink, Gereon R. and Drzezga,
                      Alexander and Schmidt, Matthias and Langen, Karl-Josef},
      title        = {{D}iagnosis of pseudoprogression in patients with
                      glioblastoma using
                      {O}-(2-[$^{18}${F}]fluoroethyl)-l-tyrosine {PET}},
      journal      = {European journal of nuclear medicine and molecular imaging},
      volume       = {42},
      number       = {5},
      issn         = {1619-7089},
      address      = {Heidelberg [u.a.]},
      publisher    = {Springer-Verl.},
      reportid     = {FZJ-2014-06569},
      pages        = {685-695},
      year         = {2015},
      abstract     = {PurposeThe follow-up of glioblastoma patients after
                      radiochemotherapy with conventional MRI can be difficult
                      since reactive alterations to the blood–brain barrier with
                      contrast enhancement may mimic tumour progression (i.e.
                      pseudoprogression, PsP). The aim of this study was to assess
                      the clinical value of O-(2-18F-fluoroethyl)-l-tyrosine
                      (18F-FET) PET in the differentiation of PsP and early tumour
                      progression (EP) after radiochemotherapy of
                      glioblastoma.MethodsA group of 22 glioblastoma patients with
                      new contrast-enhancing lesions or lesions showing increased
                      enhancement (>25 $\%)$ on standard MRI within the first 12
                      weeks after completion of radiochemotherapy with concomitant
                      temozolomide (median 7 weeks) were additionally examined
                      using amino acid PET with 18F-FET. Maximum and mean
                      tumour-to-brain ratios (TBRmax, TBRmean) were determined.
                      18F-FET uptake kinetic parameters (i.e. patterns of
                      time–activity curves, TAC) were also evaluated.
                      Classification as PsP or EP was based on the clinical course
                      (no treatment change at least for 6 months), follow-up MR
                      imaging and/or histopathological findings. Imaging results
                      were also related to overall survival (OS).ResultsPsP was
                      confirmed in 11 of the 22 patients. In patients with PsP,
                      18F-FET uptake was significantly lower than in patients with
                      EP (TBRmax 1.9 ± 0.4 vs. 2.8 ± 0.5, TBRmean
                      1.8 ± 0.2 vs. 2.3 ± 0.3; both P < 0.001) and
                      presence of MGMT promoter methylation was significantly more
                      frequent (P = 0.05). Furthermore, a TAC type II or III
                      was more frequently present in patients with EP
                      (P = 0.04). Receiver operating characteristic analysis
                      showed that the optimal 18F-FET TBRmax cut-off value for
                      identifying PsP was 2.3 (sensitivity 100 $\%,$ specificity
                      91 $\%,$ accuracy 96 $\%,$ AUC 0.94 ± 0.06;
                      P < 0.001). Univariate survival analysis showed that a
                      TBRmax <2.3 predicted a significantly longer OS (median OS
                      23 vs. 12 months; P = 0.046).Conclusion18F-FET PET may
                      facilitate the diagnosis of PsP following radiochemotherapy
                      of glioblastoma.},
      cin          = {INM-3 / INM-4},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      UT           = {WOS:000350686300004},
      pubmed       = {pmid:25411133},
      doi          = {10.1007/s00259-014-2959-4},
      url          = {https://juser.fz-juelich.de/record/173156},
}