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000061776 084__ $$2WoS$$aRadiology, Nuclear Medicine & Medical Imaging
000061776 1001_ $$0P:(DE-HGF)0$$aFloeth, F. W.$$b0
000061776 245__ $$aPrognostic value of 18F-fluoroethyl-L-tyrosine PET and MRI in small nonspecific incidental brain lesions
000061776 260__ $$aNew York, NY$$bSociety of Nuclear Medicine$$c2008
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000061776 520__ $$aNonspecific incidental brain lesions (NILs) are being detected more frequently because of an increasing number of screening or research MRI scans of the brain, and their natural course is uncertain.In a prospective cohort study starting in 1999, we determined the outcomes of patients with incidental, nonenhancing, supratentorial, lobar, and small-volume (<10 mL) lesions, depending on the findings of MRI and PET with the (18)F-labeled amino acid fluoroethyl-l-tyrosine ((18)F-FET). Patients with seizures, focal neurologic deficits, signs of local or systemic infection or inflammation, known brain disease, or any kind of previous cerebral treatment were excluded. Finally, 21 patients were eligible. MRI was performed in 19 of these patients because of nonspecific symptoms (such as headaches, dizziness, or sudden deafness), whereas 2 patients were healthy volunteers in MRI studies. Clinical follow-up and MRI scans were obtained at 4- to 6-mo intervals, and follow-up ranged from 3 to 8.5 y. Mean lesion-to-brain (L/B) ratios of >or=1.6 on (18)F-FET PET were rated as positive.Four different outcome groups were identified. In group A, 5 NILs regressed or vanished completely. All of these lesions were circumscribed on MRI, and (18)F-FET uptake was negative, with an L/B ratio of 1.2+/-0.2 (mean +/- SD). In group B, 10 NILs were stable, without growth. All of these lesions were circumscribed on MRI, and (18)F-FET uptake was negative (L/B ratio: 1.0+/-0.1). In group C, 2 NILs grew slowly over years, and an astrocytoma of World Health Organization (WHO) grade II was diagnosed after resection in each case. The lesions were circumscribed on MRI, and (18)F-FET uptake was negative (L/B ratios: 0.7 and 1.0). In group D, 4 NILs showed sudden and rapid growth, with clinical deterioration, and a high-grade glioma of WHO grade III or IV was diagnosed after resection in all cases. The lesions were diffuse on MRI, and (18)F-FET uptake was significantly increased (L/B ratio: 2.0+/-0.4) (P<0.01 for group D vs. group A or group B).For NILs, a circumscribed growth pattern on MRI and normal or low (18)F-FET uptake on PET are strong predictors for a benign course, with the eventual development of a low-grade glioma. In contrast, NILs with a diffuse growth pattern on MRI and increased (18)F-FET uptake indicate a high risk for the development of a high-grade glioma.
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000061776 650_2 $$2MeSH$$aAdolescent
000061776 650_2 $$2MeSH$$aAdult
000061776 650_2 $$2MeSH$$aAged
000061776 650_2 $$2MeSH$$aBrain: pathology
000061776 650_2 $$2MeSH$$aChild
000061776 650_2 $$2MeSH$$aDisease Progression
000061776 650_2 $$2MeSH$$aFemale
000061776 650_2 $$2MeSH$$aGlioma: metabolism
000061776 650_2 $$2MeSH$$aGlioma: pathology
000061776 650_2 $$2MeSH$$aGlioma: radionuclide imaging
000061776 650_2 $$2MeSH$$aHumans
000061776 650_2 $$2MeSH$$aMagnetic Resonance Imaging
000061776 650_2 $$2MeSH$$aMale
000061776 650_2 $$2MeSH$$aMiddle Aged
000061776 650_2 $$2MeSH$$aPositron-Emission Tomography: methods
000061776 650_2 $$2MeSH$$aPrognosis
000061776 650_2 $$2MeSH$$aTyrosine: analogs & derivatives
000061776 650_2 $$2MeSH$$aTyrosine: diagnostic use
000061776 650_7 $$00$$2NLM Chemicals$$aO-(2-fluoroethyl)tyrosine
000061776 650_7 $$055520-40-6$$2NLM Chemicals$$aTyrosine
000061776 650_7 $$2WoSType$$aJ
000061776 65320 $$2Author$$aincidental finding
000061776 65320 $$2Author$$anonspecific brain lesions
000061776 65320 $$2Author$$aF-18-fluoroethyl-L-tyrosine
000061776 65320 $$2Author$$aPET
000061776 65320 $$2Author$$aMRI
000061776 65320 $$2Author$$aprognosis
000061776 7001_ $$0P:(DE-HGF)0$$aSabel, M.$$b1
000061776 7001_ $$0P:(DE-Juel1)131627$$aStoffels, G.$$b2$$uFZJ
000061776 7001_ $$0P:(DE-HGF)0$$aPauleit, D.$$b3
000061776 7001_ $$0P:(DE-Juel1)VDB551$$aHamacher, K.$$b4$$uFZJ
000061776 7001_ $$0P:(DE-HGF)0$$aSteiger, H. J.$$b5
000061776 7001_ $$0P:(DE-Juel1)131777$$aLangen, K. J.$$b6$$uFZJ
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