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@ARTICLE{Rhrich:136793,
      author       = {M. Röhrich and K. Huang and D. Schrimpf and N. L. Albert
                      and T. Hielscher$^*$ and A. von Deimling and U. Schüller
                      and A. Dimitrakopoulou-Strauss$^*$ and U. Haberkorn$^*$},
      title        = {{I}ntegrated analysis of dynamic {FET} {PET}/{CT}
                      parameters, histology, and methylation profiling of 44
                      gliomas.},
      journal      = {European journal of nuclear medicine and molecular imaging},
      volume       = {45},
      number       = {9},
      issn         = {1619-7089},
      address      = {Heidelberg [u.a.]},
      publisher    = {Springer-Verl.},
      reportid     = {DKFZ-2018-01231},
      pages        = {1573 - 1584},
      year         = {2018},
      abstract     = {Dynamic 18F-FET PET/CT is a powerful tool for the diagnosis
                      of gliomas.18F-FET PET time-activity curves (TAC) allow
                      differentiation between histological low-grade gliomas (LGG)
                      and high-grade gliomas (HGG). Molecular methods such as
                      epigenetic profiling are of rising importance for glioma
                      grading and subclassification. Here, we analysed dynamic
                      18F-FET PET data, and the histological and epigenetic
                      features of 44 gliomas.Dynamic 18F-FET PET was performed in
                      44 patients with newly diagnosed, untreated glioma: 10 WHO
                      grade II glioma, 13 WHO grade III glioma and 21 glioblastoma
                      (GBM). All patients underwent stereotactic biopsy or tumour
                      resection after 18F-FET PET imaging. As well as histological
                      analysis of tissue samples, DNA was subjected to epigenetic
                      analysis using the Illumina 850 K methylation array. TACs,
                      standardized uptake values corrected for background uptake
                      in healthy tissue (SUVmax/BG), time to peak (TTP) and
                      kinetic modelling parameters were correlated with
                      histological diagnoses and with epigenetic signatures.
                      Multivariate analyses were performed to evaluate the
                      diagnostic accuracy of 18F-FET PET in relation to the tumour
                      groups identified by histological and methylation-based
                      analysis.Epigenetic profiling led to substantial tumour
                      reclassification, with six grade II/III gliomas reclassified
                      as GBM. Overlap of HGG-typical TACs and LGG-typical TACs was
                      dramatically reduced when tumours were clustered on the
                      basis of their methylation profile. SUVmax/BG values of GBM
                      were higher than those of LGGs following both histological
                      diagnosis and methylation-based diagnosis. The differences
                      in TTP between GBMs and grade II/III gliomas were greater
                      following methylation-based diagnosis than following
                      histological diagnosis. Kinetic modeling showed that
                      relative K1 and fractal dimension (FD) values significantly
                      differed in histology- and methylation-based GBM and grade
                      II/III glioma between those diagnosed histologically and
                      those diagnosed by methylation analysis. Multivariate
                      analysis revealed slightly greater diagnostic accuracy with
                      methylation-based diagnosis. IDH-mutant gliomas and GBM
                      subgroups tended to differ in their 18F-FET PET kinetics.The
                      status of dynamic 18F-FET PET as a biologically and
                      clinically relevant imaging modality is confirmed in the
                      context of molecular glioma diagnosis.},
      cin          = {C060 / E060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331 / I:(DE-He78)E060-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29732524},
      doi          = {10.1007/s00259-018-4009-0},
      url          = {https://inrepo02.dkfz.de/record/136793},
}