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@ARTICLE{Filss:872736,
      author       = {Filss, Christian P and Schmitz, Ann k and Stoffels,
                      Gabriele and Stegmayr, Carina and Lohmann, Philipp and
                      Werner, Jan Michael and Sabel, Michael and Rapp, Marion and
                      Goldbrunner, Roland and Neumaier, Bernd and Mottaghy, Felix
                      M. and Shah, N. Jon and Fink, Gereon R and Galldiks, Norbert
                      and Langen, Karl Josef},
      title        = {{F}lare phenomenon in {O}-(2-[ 18
                      {F}]-{F}luoroethyl)-{L}-{T}yrosine {PET} after resection of
                      gliomas},
      journal      = {Journal of nuclear medicine},
      volume       = {61},
      number       = {9},
      issn         = {0022-3123},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {FZJ-2020-00214},
      pages        = {1294-1299},
      year         = {2020},
      abstract     = {PET using O-(2-[18F]Fluoroethyl)-L-tyrosine (18F-FET) is
                      useful to detect residual tumor tissue after glioma
                      resection. Recent animal experiments detected reactive
                      changes of 18F-FET uptake at the rim of the resection cavity
                      within the first two weeks after resection of gliomas. In
                      the present study, we evaluated pre- and postoperative
                      18F-FET PET scans of glioma patients with particular
                      emphasis on the identification of reactive changes after
                      surgery. Methods: Forty-three patients with cerebral gliomas
                      (9 low-grade, 34 high-grade; 9 primary tumors, 34 recurrent
                      tumors) who had preoperative (time before surgery, median 23
                      d, range 6-44 d) and postoperative 18F-FET-PET (time after
                      surgery, median 14, range 5–28 d) were included. PET scans
                      (20-40 min p.i.) were evaluated visually for complete or
                      incomplete resection (CR, IR) and compared with MRI. Changes
                      of 18F-FET-uptake in residual tumor were evaluated by
                      tumor-to-brain ratios (TBRmax) and in the vicinity of the
                      resection cavity by maximum lesion-to-brain ratios (LBRmax).
                      Results: Visual analysis of 18F-FET PET scans revealed CR in
                      16/43 patients and IR in the remaining patients. PET results
                      were concordant with MRI in $69\%$ of the patients. LBRmax
                      of 18F-FET uptake in the vicinity of the resection cavity
                      was significantly higher compared with preoperative values
                      (1.59 ± 0.36 versus 1.14 ± 0.17; n = 43, p<0.001). In 11
                      patients $(26\%)$ a “flare phenomenon” was observed with
                      a considerable increase of 18F-FET uptake compared with
                      preoperative values in either the residual tumor (n = 5) or
                      in areas remote from tumor in the preoperative PET scan (n =
                      6) (2.92 ± 1.24 versus 1.62 ± 0.75; p<0.001). Further
                      follow-up in five patients showed decreasing 18F-FET uptake
                      in the flare areas in four and progress in one case.
                      Conclusion: Our study confirms that 18F-FET PET provides
                      valuable information for assessing the success of glioma
                      resection. Postoperative reactive changes at the rim of the
                      resection cavity appear to be mild. However, in 23 $\%$ of
                      the patients, a postoperative “flare phenomenon” was
                      observed that warrants further investigation.},
      cin          = {INM-4 / INM-3 / INM-5},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-4-20090406 / I:(DE-Juel1)INM-3-20090406 /
                      I:(DE-Juel1)INM-5-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32005771},
      UT           = {WOS:000568832100013},
      doi          = {10.2967/jnumed.119.238568},
      url          = {https://juser.fz-juelich.de/record/872736},
}