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@ARTICLE{Keil:128685,
      author       = {V. C. Keil and M. Warmuth-Metz and C. Reh and S. J. Enkirch
                      and C. Reinert and D. Beier and D. T. W. Jones$^*$ and T.
                      Pietsch and H. H. Schild and E. Hattingen and P. Hau},
      title        = {{I}maging {B}iomarkers for {A}dult {M}edulloblastomas:
                      {G}enetic {E}ntities {M}ay {B}e {I}dentified by {T}heir {MR}
                      {I}maging {R}adiophenotype.},
      journal      = {American journal of neuroradiology},
      volume       = {38},
      number       = {10},
      issn         = {1936-959X},
      address      = {Oak Brook, Ill.},
      publisher    = {Soc.},
      reportid     = {DKFZ-2017-04700},
      pages        = {1892 - 1898},
      year         = {2017},
      abstract     = {The occurrence of medulloblastomas in adults is rare;
                      nevertheless, these tumors can be subdivided into genetic
                      and histologic entities each having distinct prognoses. This
                      study aimed to identify MR imaging biomarkers to classify
                      these entities and to uncover differences in MR imaging
                      biomarkers identified in pediatric medulloblastomas.Eligible
                      preoperative MRIs from 28 patients (11 women; 22-53 years of
                      age) of the Multicenter Pilot-study for the Therapy of
                      Medulloblastoma of Adults (NOA-7) cohort were assessed by 3
                      experienced neuroradiologists. Lesions and perifocal edema
                      were volumetrized and multiparametrically evaluated for
                      classic morphologic characteristics, location,
                      hydrocephalus, and Chang criteria. To identify MR imaging
                      biomarkers, we correlated genetic entities sonic hedgehog
                      (SHH) TP53 wild type, wingless (WNT), and non-WNT/non-SHH
                      medulloblastomas (in adults, Group 4), and histologic
                      entities were correlated with the imaging criteria. These MR
                      imaging biomarkers were compared with corresponding data
                      from a pediatric study.There were 19 SHH TP53 wild type
                      $(69\%),$ 4 WNT-activated $(14\%),$ and 5 Group 4 $(17\%)$
                      medulloblastomas. Six potential MR imaging biomarkers were
                      identified, 3 of which, hydrocephalus (P = .03),
                      intraventricular macrometastases (P = .02), and hemorrhage
                      (P = .04), when combined, could identify WNT medulloblastoma
                      with $100\%$ sensitivity and $88.3\%$ specificity $(95\%$
                      CI, $39.8\%-100.0\%$ and $62.6\%-95.3\%).$ WNT-activated
                      nuclear β-catenin accumulating medulloblastomas were
                      smaller than the other entities $(95\%$ CI, 5.2-22.3 cm(3)
                      versus 35.1-47.6 cm(3); P = .03). Hemorrhage was exclusively
                      present in non-WNT/non-SHH medulloblastomas (P = .04; n =
                      2/5). MR imaging biomarkers were all discordant from those
                      identified in the pediatric cohort. Desmoplastic/nodular
                      medulloblastomas were more rarely in contact with the fourth
                      ventricle (4/15 versus 7/13; P = .04).MR imaging biomarkers
                      can help distinguish histologic and genetic medulloblastoma
                      entities in adults and appear to be different from those
                      identified in children.},
      cin          = {B062},
      ddc          = {610},
      cid          = {I:(DE-He78)B062-20160331},
      pnm          = {312 - Functional and structural genomics (POF3-312)},
      pid          = {G:(DE-HGF)POF3-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:28798218},
      doi          = {10.3174/ajnr.A5313},
      url          = {https://inrepo02.dkfz.de/record/128685},
}