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@ARTICLE{DAmore:891051,
      author       = {D’Amore, Francesco and Grinberg, Farida and Mauler, Jörg
                      and Galldiks, Norbert and Blazhenets, Ganna and Farrher,
                      Ezequiel and Filss, Christian and Stoffels, Gabriele and
                      Mottaghy, Felix M and Lohmann, Philipp and Shah, N Jon and
                      Langen, Karl-Josef},
      title        = {{C}ombined 18{F}-{FET} {PET} and diffusion kurtosis {MRI}
                      in post-treatment glioblastoma: differentiation of true
                      progression from treatment related changes},
      journal      = {Neuro-oncology advances},
      volume       = {3},
      number       = {1},
      issn         = {2632-2498},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {FZJ-2021-01337},
      pages        = {vdab044},
      year         = {2021},
      abstract     = {BackgroundRadiological differentiation of tumor progression
                      (TPR) from treatment-related changes (TRC) in pretreated
                      glioblastoma is crucial. This study aimed to explore the
                      diagnostic value of diffusion kurtosis MRI combined with
                      information derived from O-(2-[18F]-fluoroethyl)-l-tyrosine
                      (18F-FET) PET for the differentiation of TPR from TRC in
                      patients with pretreated glioblastoma.MethodsThirty-two
                      patients with histomolecularly defined and pretreated
                      glioblastoma suspected of having TPR were included in this
                      retrospective study. Twenty-one patients were included in
                      the TPR group, and 11 patients in the TRC group, as assessed
                      by neuropathology or clinicoradiological follow-up.
                      Three-dimensional (3D) regions of interest were generated
                      based on increased 18F-FET uptake using a tumor-to-brain
                      ratio of 1.6. Furthermore, diffusion MRI kurtosis maps were
                      obtained from the same regions of interest using
                      co-registered 18F-FET PET images, and advanced histogram
                      analysis of diffusion kurtosis map parameters was applied to
                      generated 3D regions of interest. Diagnostic accuracy was
                      analyzed by receiver operating characteristic curve analysis
                      and combinations of PET and MRI parameters using
                      multivariate logistic regression.ResultsParameters derived
                      from diffusion MRI kurtosis maps show high diagnostic
                      accuracy, up to $88\%,$ for differentiating between TPR and
                      TRC. Logistic regression revealed that the highest
                      diagnostic accuracy of $94\%$ (area under the curve, 0.97;
                      sensitivity, $94\%;$ specificity, $91\%)$ was achieved by
                      combining the maximum tumor-to-brain ratio of 18F-FET uptake
                      and diffusion MRI kurtosis metrics.ConclusionsThe combined
                      use of 18F-FET PET and MRI diffusion kurtosis maps appears
                      to be a promising approach to improve the differentiation of
                      TPR from TRC in pretreated glioblastoma and warrants further
                      investigation.},
      cin          = {INM-4 / JARA-BRAIN / INM-11},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-4-20090406 / I:(DE-Juel1)VDB1046 /
                      I:(DE-Juel1)INM-11-20170113},
      pnm          = {525 - Decoding Brain Organization and Dysfunction
                      (POF4-525)},
      pid          = {G:(DE-HGF)POF4-525},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {34013207},
      UT           = {WOS:000905125400067},
      doi          = {10.1093/noajnl/vdab044},
      url          = {https://juser.fz-juelich.de/record/891051},
}