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@ARTICLE{Piechotta:132727,
      author       = {P. L. Piechotta and D. Bonekamp$^*$ and M. Sill$^*$ and A.
                      Wick and W. Wick$^*$ and M. Bendszus and P. Kickingereder},
      title        = {{I}ncreased {D}elay {B}etween {G}adolinium {C}helate
                      {A}dministration and {T}1-{W}eighted {M}agnetic {R}esonance
                      {I}maging {A}cquisition {I}ncreases {C}ontrast-{E}nhancing
                      {T}umor {V}olumes and {T}1 {I}ntensities in {B}rain {T}umor
                      {P}atients.},
      journal      = {Investigative radiology},
      volume       = {53},
      number       = {4},
      issn         = {0020-9996},
      address      = {Philadelphia, Pa.},
      publisher    = {Lippincott Williams $\&$ Wilkins},
      reportid     = {DKFZ-2018-00381},
      pages        = {223 - 228},
      year         = {2018},
      abstract     = {The aim of this study was to evaluate the impact of delayed
                      T1-weighted (T1-w) MRI acquisition after gadolinium chelate
                      administration on brain tumor volumes and T1-w
                      intensities.Fifty-five patients with histologically
                      confirmed, contrast-enhancing intra-axial brain tumors were
                      analyzed in this prospective test-retest study. Patients
                      underwent 2 consecutive 3 T MRI scans (separated by a
                      1-minute break) during routine follow-up with
                      contrast-enhanced T1 (ceT1-w), T2, and FLAIR acquisition.
                      Macrocyclic gadolinium chelate-based contrast agent was only
                      administered before the first ceT1-w acquisition; median
                      latency to ceT1-w acquisition was 6.72 minutes (IQR,
                      6.53-6.92) in the first and 16.27 minutes (IQR, 15.49-17.26)
                      in the second scan. Changes in tumor volumes and relative
                      ceT1-w intensities between the 2 acquisitions were
                      quantitatively assessed following semiautomated tumor
                      segmentation (separately for contrast-enhancement [CE],
                      necrosis [NEC], and nonenhancing [NE]
                      tumor).Semiautomatically segmented CE tumor volumes were
                      significantly larger in the second acquisition (median
                      $+32\%$ [1.2 cm]; IQR, $16\%-62\%;$ P < 0.01), which
                      corresponded to a $10\%$ increase in CE tumor diameter (+0.3
                      cm). Contrarily, NEC and NE tumor volumes were significantly
                      smaller (median $-24\%$ [IQR, $-36\%$ to $-54\%],$ P < 0.01
                      for NEC and $-2\%$ [IQR, $-1\%$ to $-3\%],$ P = 0.02 for NE
                      tumor). Bland-Altman plots confirmed a proportional bias
                      toward higher CE and lower NEC volumes for the second ceT1-w
                      acquisition. Relative ceT1-w intensities for both early-
                      (regions already enhancing in the first scan) and
                      late-enhancing (newly enhancing regions in the second scan)
                      tumor were significantly increased in the second acquisition
                      (by $5.8\%$ and $27.3\%$ [P < 0.01, respectively]).
                      Linear-mixed effects modeling confirmed that the increase in
                      CE volumes and CE intensities is a function of the interval
                      between contrast agent injection and ceT1-w acquisition (P <
                      0.01 each).Our study indicates that the maximum extent of CE
                      tumor volumes and intensities may increase beyond the time
                      frame of 4 to 8 minutes after contrast agent injection and
                      potentially affects the diagnosis of progressive or
                      recurrent disease because late-enhancing recurrent disease
                      might not be unequivocally detected on standard follow-up
                      MRI.},
      cin          = {E010 / C060 / L101 / G370},
      ddc          = {610},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)C060-20160331 /
                      I:(DE-He78)L101-20160331 / I:(DE-He78)G370-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29200014},
      doi          = {10.1097/RLI.0000000000000432},
      url          = {https://inrepo02.dkfz.de/record/132727},
}