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@ARTICLE{DeikeHofmann:132797,
      author       = {K. Deike-Hofmann$^*$ and D. Thünemann$^*$ and M.
                      Breckwoldt$^*$ and D. Schwarz$^*$ and A. Radbruch$^*$ and A.
                      Enk and M. Bendszus and J. Hassel and H.-P. Schlemmer$^*$
                      and P. Bäumer$^*$},
      title        = {{S}ensitivity of different {MRI} sequences in the early
                      detection of melanoma brain metastases.},
      journal      = {PLoS one},
      volume       = {13},
      number       = {3},
      issn         = {1932-6203},
      address      = {Lawrence, Kan.},
      publisher    = {PLoS},
      reportid     = {DKFZ-2018-00441},
      pages        = {e0193946 -},
      year         = {2018},
      abstract     = {After the emergence of new MRI techniques such as
                      susceptibility- and diffusion-weighted imaging (SWI and DWI)
                      and because of specific imaging characteristics of melanoma
                      brain metastases (MBM), it is unclear which MRI sequences
                      are most beneficial for detection of MBM. This study was
                      performed to investigate the sensitivity of six clinical MRI
                      sequences in the early detection of MBM.Medical records of
                      all melanoma patients referred to our center between
                      November 2005 and December 2016 were reviewed for presence
                      of MBM. Analysis encompassed six MRI sequences at the time
                      of initial diagnosis of first or new MBM, including
                      non-enhanced T1-weighted (T1w), contrast-enhanced T1w
                      (ceT1w), T2-weighted (T2w), T2w-FLAIR,
                      susceptibility-weighted (SWI) and diffusion-weighted (DWI)
                      MRI. Each lesion was rated with respect to its conspicuity
                      (score from 0-not detectable to 3-clearly visible).Of 1210
                      patients, 217 with MBM were included in the analysis and up
                      to 5 lesions per patient were evaluated. A total of 720
                      metastases were assessed and all six sequences were
                      available for 425 MBM. Sensitivity (conspicuity ≥2) was
                      $99.7\%$ for ceT1w, $77.0\%$ for FLAIR, $64.7\%$ for SWI,
                      $61.0\%$ for T2w, $56.7\%$ for T1w, and $48.4\%$ for DWI.
                      Thirty-one $(7.3\%)$ of 425 lesions were only detectable by
                      ceT1w but no other sequence.Contrast-enhanced T1-weighting
                      is more sensitive than all other sequences for detection of
                      MBM. Disruption of the blood-brain-barrier is consistently
                      an earlier sign in MBM than perifocal edema, signal loss on
                      SWI or diffusion restriction.},
      cin          = {E010 / E012},
      ddc          = {500},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)E012-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29596475},
      pmc          = {pmc:PMC5875773},
      doi          = {10.1371/journal.pone.0193946},
      url          = {https://inrepo02.dkfz.de/record/132797},
}