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@ARTICLE{Galldiks:862734,
      author       = {Galldiks, Norbert and Unterrainer, Marcus and Judov,
                      Natalie and Stoffels, Gabriele and Rapp, Marion and Lohmann,
                      Philipp and Vettermann, Franziska and Dunkl, Veronika and
                      Suchorska, Bogdana and Tonn, Jörg C and Kreth,
                      Friedrich-Wilhem and Fink, Gereon Rudolf and Bartenstein,
                      Peter and Langen, Karl-Josef and Albert, Nathalie L},
      title        = {{P}hotopenic defects on
                      {O}-(2-[18{F}]-fluoroethyl)-{L}-tyrosine {PET} - {C}linical
                      relevance in glioma patients},
      journal      = {Neuro-Oncology},
      volume       = {21},
      number       = {10},
      issn         = {1523-5866},
      address      = {Oxford},
      publisher    = {Oxford Univ. Press},
      reportid     = {FZJ-2019-02976},
      pages        = {1331-1338},
      year         = {2019},
      abstract     = {BackgroundO-(2-[18F]-fluoroethyl)-L-tyrosine (FET) PET has
                      a sensitivity of more than $90\%$ to detect gliomas. In the
                      remaining small fraction of gliomas without increased tracer
                      uptake, some tumors even show photopenic defects whose
                      clinical significance is unclear.MethodsGlioma patients with
                      a negative FET PET scan prior to neuropathological
                      confirmation were identified retrospectively. Gliomas were
                      rated visually as (i) having indifferent FET uptake or (ii)
                      photopenic, if FET uptake was below background activity. FET
                      uptake in the area of signal hyperintensity on the T2/fluid
                      attenuated inversion recovery–weighted MRI was evaluated
                      by mean standardized uptake value (SUV) and mean
                      tumor-to-brain ratio (TBR). The progression-free survival
                      (PFS) of photopenic gliomas was compared with that of
                      gliomas with indifferent FET uptake.ResultsOf 100
                      FET-negative gliomas, 40 cases with photopenic defects were
                      identified. Fifteen of these 40 cases $(38\%)$ had World
                      Health Organization (WHO) grades III and IV gliomas. FET
                      uptake in photopenic gliomas was significantly decreased
                      compared with both the healthy-appearing brain tissue (SUV,
                      0.89 ± 0.26 vs 1.08 ± 0.23; P < 0.001) and gliomas with
                      indifferent FET uptake (TBR, 0.82 ± 0.09 vs 0.96 ± 0.13; P
                      < 0.001). Irrespective of the applied treatment, isocitrate
                      dehydrogenase (IDH)–mutated WHO grade II diffuse
                      astrocytoma patients with indifferent FET uptake (n = 25)
                      had a significantly longer PFS than patients with
                      IDH-mutated diffuse astrocytomas (WHO grade II) with
                      photopenic defects (n = 11) (51 vs 24 mo; P = 0.027). The
                      multivariate survival analysis indicated that photopenic
                      defects predict an unfavorable PFS (P =
                      0.009).ConclusionPhotopenic gliomas in negative FET PET
                      scans should be managed more actively, as they seem to have
                      a higher risk of harboring a higher-grade glioma and an
                      unfavorable outcome.},
      cin          = {INM-3 / INM-4},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406 / I:(DE-Juel1)INM-4-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31077276},
      UT           = {WOS:000493086800015},
      doi          = {10.1093/neuonc/noz083},
      url          = {https://juser.fz-juelich.de/record/862734},
}