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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},
}