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@INPROCEEDINGS{Werner:864920,
author = {Werner, J. M. and Stoffels, G. and Lichtenstein, T. and
Borggrefe, J. and Lohmann, P. and Ceccon, G. and Shah, N. J.
and Fink, G. R. and Langen, K. J. and Kabbasch, C. and
Galldiks, N.},
title = {{D}ifferentiation of treatment-related changes from tumor
progression: {A} direct comparison between dynamic {FET}
{PET} and {ADC} values obtained from {DWI} {MRI}},
reportid = {FZJ-2019-04523},
year = {2019},
abstract = {V29Differentiation of treatment-related changes from
high-grade glioma progression: A direct comparison between
FET PET and ADC values obtained by DWI MRIJ. Werner1, G.
Stoffels2, T. Lichtenstein3, J. Borggrefe3, G. Ceccon1, N.
J. Shah2, G. R. Fink1, K. J. Langen2, C. Kabbasch3, N.
Galldiks11University Hospital Cologne, Dept. of Neurology,
Cologne; 2Research Center Jülich, Inst. of Neuroscience and
Medicine (INM-4), Jülich; 3University Hospital Cologne,
Dept. of Neuroradiology, CologneZiel/Aim:Following brain
cancer treatment, the capacity of anatomical MRI to
differentiate neoplastic tissue from treatment-related
changes such as pseudoprogression is limited. The aim of
this study was to compare apparent diffusion coefficient
(ADC) values obtained by diffusion-weighted MRI (DWI) with
static parameters of O-(2-[18F]fluoroethyl)-L-tyrosine (FET)
PET for the differentiation of treatment-related changes
from tumor progression.Methodik/Methods:Forty-eight
pretreated high-grade glioma patients (mean age, 50±15
years) with anatomical MRI findings suspicious for tumor
progression (median time after completion of last treatment,
16 weeks) were additionally investigated using DWI MRI and
FET PET. Maximum and mean tumor-to-brain ratios
(TBRmax/mean) of FET uptake were determined (20-40 minutes
post-injection). Regions-of-Interest analyses were performed
concerning the enhancing lesion on ADC maps calculated from
DWI MRI. Diagnoses were confirmed neuropathologically
$(21\%;$ 10 patients) or clinico-radiologically $(79\%;$ 38
patients). Diagnostic performances of TBRs and ADC values
for the correct differentiation were evaluated each alone
using receiver-operating-characteristic analyses, or the
Fisher Exact test for a combinational
approach.Ergebnisse/Results:Ten of 48 patients had
treatment-related changes $(21\%).$ The diagnostic
performance of FET PET was clearly higher (threshold
TBRmean, 1.95; sensitivity, $100\%;$ specificity, $79\%;$
accuracy, $83\%;$ AUC 0.89±0.05; P-3 mm2/s; sensitivity,
$60\%;$ specificity; $79\%;$ accuracy, $75\%;$ AUC
0.73±0.09; P=0.05). The combination of both imaging
parameters did not increase the accuracy $(64\%;$
P=0.144).Schlussfolgerungen/Conclusions:Static FET PET seems
to add valuable clinical information regarding the
differentiation of early treatment-related changes from
tumor progression and outperforms ADC values for this highly
relevant clinical question.},
month = {Apr},
date = {2019-04-03},
organization = {Jahrestagung der Deutschen
Gesellschaft für Nuklearmedizin 2019,
Bremen (Germany), 3 Apr 2019 - 6 Apr
2019},
cin = {INM-3 / INM-4},
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)1},
url = {https://juser.fz-juelich.de/record/864920},
}