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@ARTICLE{Galldiks:21886,
      author       = {Galldiks, N. and Langen, K.J. and Holy, R. and Pinkawa, M.
                      and Stoffels, G. and Nolte, K.W. and Kaiser, H.J. and Filss,
                      C.P. and Fink, G.R. and Coenen, H.H. and Eble, M.J. and
                      Piroth, M.D.},
      title        = {{A}ssessment of treatment response in patients with
                      glioblastoma using [18{F}]{F}luoroethyl-{L}-{T}yrosine {PET}
                      in comparison to {MRI}},
      journal      = {Journal of nuclear medicine},
      volume       = {53},
      number       = {7},
      issn         = {0161-5505},
      address      = {New York, NY},
      publisher    = {Society of Nuclear Medicine},
      reportid     = {PreJuSER-21886},
      pages        = {1048-1057},
      year         = {2012},
      note         = {Record converted from VDB: 12.11.2012},
      abstract     = {The assessment of treatment response in glioblastoma is
                      difficult with MRI because reactive blood-brain barrier
                      alterations with contrast enhancement can mimic tumor
                      progression. In this study, we investigated the predictive
                      value of PET using O-(2-(18)F-fluoroethyl)-l-tyrosine
                      ((18)F-FET PET) during treatment.In a prospective study, 25
                      patients with glioblastoma were investigated by MRI and
                      (18)F-FET PET after surgery (MRI-/FET-1), early (7-10 d)
                      after completion of radiochemotherapy with temozolomide
                      (RCX) (MRI-/FET-2), and 6-8 wk later (MRI-/FET-3). Maximum
                      and mean tumor-to-brain ratios (TBR(max) and TBR(mean),
                      respectively) were determined by region-of-interest
                      analyses. Furthermore, gadolinium contrast-enhancement
                      volumes on MRI (Gd-volume) and tumor volumes in (18)F-FET
                      PET images with a tumor-to-brain ratio greater than 1.6
                      (T(vol 1.6)) were calculated using threshold-based
                      volume-of-interest analyses. The patients were grouped into
                      responders and nonresponders according to the changes of
                      these parameters at different cutoffs, and the influence on
                      progression-free survival and overall survival was tested
                      using univariate and multivariate survival analyses and by
                      receiver-operating-characteristic analyses.Early after
                      completion of RCX, a decrease of both TBR(max) and TBR(mean)
                      was a highly significant and independent statistical
                      predictor for progression-free survival and overall
                      survival. Receiver-operating-characteristic analysis showed
                      that a decrease of the TBR(max) between FET-1 and FET-2 of
                      more than $20\%$ predicted poor survival, with a sensitivity
                      of $83\%$ and a specificity of $67\%$ (area under the curve,
                      0.75). Six to eight weeks later, the predictive value of
                      TBR(max) and TBR(mean) was less significant, but an
                      association between a decrease of T(vol 1.6) and PFS was
                      noted. In contrast, Gd-volume changes had no significant
                      predictive value for survival.In contrast to Gd-volumes on
                      MRI, changes in (18)F-FET PET may be a valuable parameter to
                      assess treatment response in glioblastoma and to predict
                      survival time.},
      keywords     = {Adult / Aged / Brain Neoplasms: radionuclide imaging /
                      Brain Neoplasms: therapy / Chemoradiotherapy / Contrast
                      Media / Disease Progression / Disease-Free Survival / Female
                      / Gadolinium / Glioblastoma: radionuclide imaging /
                      Glioblastoma: therapy / Humans / Kaplan-Meier Estimate /
                      Magnetic Resonance Imaging / Male / Middle Aged /
                      Neurosurgical Procedures / Positron-Emission Tomography /
                      Prognosis / Proportional Hazards Models / Prospective
                      Studies / Radiopharmaceuticals: diagnostic use / Survival
                      Analysis / Treatment Outcome / Tyrosine: analogs $\&$
                      derivatives / Tyrosine: diagnostic use /
                      (18F)fluoroethyltyrosine (NLM Chemicals) / Contrast Media
                      (NLM Chemicals) / Radiopharmaceuticals (NLM Chemicals) /
                      Tyrosine (NLM Chemicals) / Gadolinium (NLM Chemicals) / J
                      (WoSType)},
      cin          = {INM-3 / INM-4 / INM-5},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406 /
                      I:(DE-Juel1)INM-5-20090406},
      pnm          = {Funktion und Dysfunktion des Nervensystems (FUEK409) /
                      89572 - (Dys-)function and Plasticity (POF2-89572)},
      pid          = {G:(DE-Juel1)FUEK409 / G:(DE-HGF)POF2-89572},
      shelfmark    = {Radiology, Nuclear Medicine $\&$ Medical Imaging},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:22645298},
      UT           = {WOS:000306164600020},
      doi          = {10.2967/jnumed.111.098590},
      url          = {https://juser.fz-juelich.de/record/21886},
}