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@ARTICLE{Flechsig:136713,
      author       = {P. Flechsig and C. Walker and C. Kratochwil and L. König
                      and A. Iagura and J. Moltz and T. Holland-Letz$^*$ and H.-U.
                      Kauczor and U. Haberkorn$^*$ and F. Giesel$^*$},
      title        = {{R}ole of {CT} {D}ensity in {PET}/{CT}-{B}ased {A}ssessment
                      of {L}ymphoma.},
      journal      = {Molecular imaging $\&$ biology},
      volume       = {20},
      number       = {4},
      issn         = {1860-2002},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2018-01151},
      pages        = {641 - 649},
      year         = {2018},
      abstract     = {In patients with Hodgkin (HL) and non-Hodgkin lymphoma
                      (NHL), primary staging, as well as intermediate and late
                      response assessment, is often performed by integrated
                      2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) positron emission
                      tomography/X-ray computed tomography (PET/CT). The purpose
                      of this analysis was to evaluate if findings in patients
                      with histopathologically proven HL or NHL might correlate
                      with semi-automated density measurements of target lesions
                      (TLs) in the CT component of the integrated PET/CT
                      examination.After approval by the institutional review
                      board, 176 lymph nodes (LN) in 90 PET/CT examinations of 90
                      patients were retrospectively analyzed (HL, 108 TLs out of
                      55 patients; NHL, 68 TLs out of 35 patients). PET/CT was
                      performed for reasons of primary staging, response
                      evaluation as interim PET, or as final examination after
                      therapy, according to the clinical schedule. Analyses of TLs
                      were performed on the basis of tracer uptake (SUV) 60 min
                      after tracer injection and volumetric CT histogram analysis
                      in non-contrast-enhanced CT.All patients were diagnosed with
                      HL or NHL in a pretreatment biopsy. Prior to therapy
                      induction, staging of all patients was performed using
                      contrast-enhanced CT of the neck to the pelvis, or by
                      [18F]FDG PET/CT. Of the 176 TLs, 119 were classified as
                      malignant, and 57 were benign. Malignant TLs had
                      significantly higher CT density values compared to benign
                      (p < 0.01).Density measurements of TLs in patients with
                      HL and NHL correlate with the dignity of TLs and might
                      therefore serve as a complementary surrogate parameter for
                      the differentiation between malignant and benign TLs. A
                      possible density threshold in clinical routine might be a
                      20-Hounsfield units (HU) cutoff value to rule out benignancy
                      in TLs that are above the 20-HU threshold.},
      cin          = {E060 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)E060-20160331 / I:(DE-He78)C060-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29270848},
      doi          = {10.1007/s11307-017-1155-x},
      url          = {https://inrepo02.dkfz.de/record/136713},
}