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@MISC{Galldiks:908214,
      author       = {Galldiks, Norbert and Werner, Jan-Michael and Stoffels,
                      Gabriele and Kocher, Martin and Tscherpel, Caroline and
                      Jain, Rajan and Shah, Nadim and Fink, Gereon and Langen,
                      Karl-Josef and Lohmann, Philipp},
      title        = {{NIMG}-05. {THE} {T}2-{FLAIR} {MISMATCH} {SIGN} {IN}
                      {IDH}-{MUTANT} {ASTROCYTOMAS} - {IS} {THERE} {AN}
                      {ASSOCIATION} {WITH} {FET} {PET} {UPTAKE}?},
      reportid     = {FZJ-2022-02465},
      year         = {2019},
      abstract     = {BACKGROUNDThe 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.},
      cin          = {INM-11 / INM-4 / JARA-BRAIN / INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-11-20170113 / I:(DE-Juel1)INM-4-20090406 /
                      I:(DE-Juel1)VDB1046 / I:(DE-Juel1)INM-3-20090406},
      pnm          = {5253 - Neuroimaging (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5253},
      typ          = {PUB:(DE-HGF)4},
      url          = {https://juser.fz-juelich.de/record/908214},
}