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@ARTICLE{Floeth:61776,
      author       = {Floeth, F. W. and Sabel, M. and Stoffels, G. and Pauleit,
                      D. and Hamacher, K. and Steiger, H. J. and Langen, K. J.},
      title        = {{P}rognostic value of 18{F}-fluoroethyl-{L}-tyrosine {PET}
                      and {MRI} in small nonspecific incidental brain lesions},
      journal      = {Journal of nuclear medicine},
      volume       = {49},
      number       = {5},
      issn         = {0161-5505},
      address      = {New York, NY},
      publisher    = {Society of Nuclear Medicine},
      reportid     = {PreJuSER-61776},
      pages        = {730-737},
      year         = {2008},
      note         = {Record converted from VDB: 12.11.2012},
      abstract     = {Nonspecific 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.},
      keywords     = {Adolescent / Adult / Aged / Brain: pathology / Child /
                      Disease Progression / Female / Glioma: metabolism / Glioma:
                      pathology / Glioma: radionuclide imaging / Humans / Magnetic
                      Resonance Imaging / Male / Middle Aged / Positron-Emission
                      Tomography: methods / Prognosis / Tyrosine: analogs $\&$
                      derivatives / Tyrosine: diagnostic use /
                      O-(2-fluoroethyl)tyrosine (NLM Chemicals) / Tyrosine (NLM
                      Chemicals) / J (WoSType)},
      cin          = {INB-3 / INB-4},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INB-3-20090406 / I:(DE-Juel1)VDB807},
      pnm          = {Funktion und Dysfunktion des Nervensystems},
      pid          = {G:(DE-Juel1)FUEK409},
      shelfmark    = {Radiology, Nuclear Medicine $\&$ Medical Imaging},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:18413396},
      UT           = {WOS:000255809100022},
      doi          = {10.2967/jnumed.107.050005},
      url          = {https://juser.fz-juelich.de/record/61776},
}