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@ARTICLE{Neuschmelting:808428,
      author       = {Neuschmelting, V. and Weiss Lucas, C. and Stoffels, G. and
                      Oros-Peusquens, Ana-Maria and Lockau, H. and Shah, N. J. and
                      Langen, Karl-Josef and Goldbrunner, R. and Grefkes, C.},
      title        = {{M}ultimodal {I}maging in {M}alignant {B}rain {T}umors:
                      {E}nhancing the {P}reoperative {R}isk {E}valuation for
                      {M}otor {D}eficits with a {C}ombined {H}ybrid {MRI}-{PET}
                      and {N}avigated {T}ranscranial {M}agnetic {S}timulation
                      {A}pproach},
      journal      = {American journal of neuroradiology},
      volume       = {37},
      number       = {2},
      issn         = {1936-959X},
      address      = {Oak Brook, Ill.},
      publisher    = {Soc.},
      reportid     = {FZJ-2016-02251},
      pages        = {266 - 273},
      year         = {2016},
      abstract     = {BACKGROUND AND PURPOSE: Motor deficits in patients with
                      brain tumors are caused mainly by irreversible infiltration
                      of the motor network or by indirect mass effects; these
                      deficits are potentially reversible on tumor removal. Here
                      we used a novel multimodal imaging approach consisting of
                      structural, functional, and metabolic neuroimaging to better
                      distinguish these underlying causes in a preoperative
                      setting and determine the predictive value of this
                      approach.MATERIALS AND METHODS: Thirty patients with
                      malignant brain tumors involving the central region
                      underwent a hybrid
                      O-(2-[18F]fluoroethyl)-L-tyrosine–PET-MR imaging and motor
                      mapping by neuronavigated transcranial magnetic stimulation.
                      The functional maps served as localizers for DTI
                      tractography of the corticospinal tract. The spatial
                      relationship between functional tissue (motor cortex and
                      corticospinal tract) and lesion volumes as depicted by
                      structural and metabolic imaging was analyzed.RESULTS: Motor
                      impairment was found in nearly all patients in whom the
                      contrast-enhanced T1WI or PET lesion overlapped functional
                      tissue. All patients who functionally deteriorated after the
                      operation showed such overlap on presurgical maps, while the
                      absence of overlap predicted a favorable motor outcome. PET
                      was superior to contrast-enhanced T1WI for revealing a motor
                      deficit before the operation. However, the best correlation
                      with clinical impairment was found for T2WI lesion overlap
                      with functional tissue maps, but the prognostic value for
                      motor recovery was not significant.CONCLUSIONS: Overlapping
                      contrast-enhanced T1WI or PET-positive signals with motor
                      functional tissue were highly indicative of motor impairment
                      and predictive for surgery-associated functional outcome.
                      Such a multimodal diagnostic approach may contribute to the
                      risk evaluation of operation-associated motor deficits in
                      patients with brain tumors.},
      cin          = {INM-3 / INM-4 / JARA-BRAIN},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406 /
                      $I:(DE-82)080010_20140620$},
      pnm          = {573 - Neuroimaging (POF3-573)},
      pid          = {G:(DE-HGF)POF3-573},
      typ          = {PUB:(DE-HGF)16},
      UT           = {WOS:000369111200018},
      pubmed       = {pmid:26514607},
      doi          = {10.3174/ajnr.A4536},
      url          = {https://juser.fz-juelich.de/record/808428},
}