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000908214 005__ 20220621190117.0
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000908214 0247_ $$2ISSN$$a1523-5866
000908214 037__ $$aFZJ-2022-02465
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000908214 1001_ $$0P:(DE-Juel1)143792$$aGalldiks, Norbert$$b0$$ufzj
000908214 245__ $$aNIMG-05. THE T2-FLAIR MISMATCH SIGN IN IDH-MUTANT ASTROCYTOMAS - IS THERE AN ASSOCIATION WITH FET PET UPTAKE?
000908214 260__ $$c2019
000908214 3367_ $$2DataCite$$aText
000908214 3367_ $$0PUB:(DE-HGF)4$$2PUB:(DE-HGF)$$aCommunication$$bcomm$$mcomm$$s1655817087_17315
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000908214 3367_ $$2ORCID$$aOTHER
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000908214 3367_ $$04$$2EndNote$$aPersonal Communication
000908214 520__ $$aBACKGROUNDThe purpose of this study was (i) to assess the reproducibility of the previously described T2-FLAIR mismatch sign as a highly specific MR imaging marker in non-enhancing IDH-mutant, 1p/19q non-codeleted lower-grade gliomas (LGG) of the WHO grades II or III, and (ii) its association with the uptake of the radiolabeled amino acid O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) in PET to further metabolically characterize that sign, which is currently poorly understood.METHODSConsecutive MRI and dynamic FET PET scans (n=134) from newly diagnosed and neuropathologically confirmed IDH-mutant LGG (n=65) and IDH-wildtype gliomas as control group (n=69) were evaluated by two independent raters to assess presence/absence of the T2-FLAIR mismatch sign as well as FET uptake. Interrater agreement was assessed using Cohen’s kappa (κ), as well as diagnostic performance (i.e., positive/negative predictive value; PPV, NPV) of the T2-FLAIR mismatch sign to identify IDH-mutant astrocytomas.RESULTSIn the LGG group, 13 patients (20%) had a T2-FLAIR mismatch sign, which could be identified with a substantial interrater agreement (κ=0.75). In contrast, that sign was absent in IDH-wildtype gliomas. All 13 cases that were positive for the T2/FLAIR mismatch sign were IDH-mutant, 1p/19q non-codeleted tumors (PPV=100%, NPV=57%). Interestingly, compared to IDH-mutant gliomas without the T2-FLAIR mismatch sign, the sign was significantly (P=0.027; 10 of 13 patients) associated with a negative FET PET scan (i.e., 5 tumors with indifferent FET uptake comparable to the background activity, or FET uptake below background activity (photopenic defect) in 5 tumors).CONCLUSIONSWith a robust interrater agreement, our findings are in line with previously reported findings regarding the T2-FLAIR mismatch sign. Additionally, the T2-FLAIR mismatch sign seems to be significantly related with a lack of increased FET uptake in PET, which may help to further characterize patients with that sign. Notwithstanding, the clinical relevance of this imaging constellation warrants further investigation.
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000908214 588__ $$aDataset connected to CrossRef, Journals: juser.fz-juelich.de
000908214 7001_ $$0P:(DE-HGF)0$$aWerner, Jan-Michael$$b1
000908214 7001_ $$0P:(DE-Juel1)131627$$aStoffels, Gabriele$$b2$$ufzj
000908214 7001_ $$0P:(DE-Juel1)173675$$aKocher, Martin$$b3$$ufzj
000908214 7001_ $$aTscherpel, Caroline$$b4
000908214 7001_ $$0P:(DE-HGF)0$$aJain, Rajan$$b5
000908214 7001_ $$0P:(DE-Juel1)131794$$aShah, Nadim$$b6$$ufzj
000908214 7001_ $$0P:(DE-Juel1)131720$$aFink, Gereon$$b7$$ufzj
000908214 7001_ $$0P:(DE-Juel1)131777$$aLangen, Karl-Josef$$b8$$ufzj
000908214 7001_ $$0P:(DE-Juel1)145110$$aLohmann, Philipp$$b9$$eCorresponding author$$ufzj
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