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@ARTICLE{Schwarz:147217,
      author       = {D. Schwarz$^*$ and T. Niederle and P. Münch$^*$ and T.
                      Hielscher$^*$ and J. C. Hassel and H.-P. Schlemmer$^*$ and
                      M. Platten$^*$ and F. Winkler$^*$ and W. Wick$^*$ and S.
                      Heiland and S. Delorme$^*$ and M. Bendszus and P. Bäumer
                      and M. Breckwoldt$^*$},
      title        = {{S}usceptibility-weighted imaging in malignant melanoma
                      brain metastasis.},
      journal      = {Journal of magnetic resonance imaging},
      volume       = {50},
      number       = {4},
      issn         = {1522-2586},
      address      = {New York, NY},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2019-02343},
      pages        = {1251 - 1259},
      year         = {2019},
      abstract     = {The value of cerebral susceptibility-weighted imaging (SWI)
                      in malignant melanoma (MM) patients remains controversial
                      and the effect of melanin on SWI is not well understood.To
                      systematically analyze the spectrum of intracerebral
                      findings in MM brain metastases (BM) on SWI and to determine
                      the diagnostic value of SWI.Retrospective.In all, 100
                      patients with melanoma BM (69 having received radiotherapy
                      [RT] and 31 RT-naïve) and a control group of 100 melanoma
                      patients without BM were included. For detailed analysis of
                      signal characteristics, 175 metastases were studied.Gradient
                      echo SWI sequence at 1.5, 3.0, and 9.4 T.Signal
                      characteristics from melanotic and amelanotic BMs on SWI
                      with a focus on blooming artifacts were analyzed, as well as
                      the presence and longitudinal dynamics of isolated SWI
                      blooming artifacts in patients with and without
                      BM.Chi-squared and Student's t-test were used for
                      contingency table measures and group data of signal and
                      clinical characteristics, respectively.Melanotic and
                      amelanotic metastases did not show significant differences
                      of SWI blooming artifacts $(38\%$ vs. $43\%,$ P = 0.61).
                      Most metastases without an initial SWI artifact developed a
                      signal dropout during follow-up $(80\%;$ 65/81). Isolated
                      SWI artifacts were detected more frequently in patients with
                      BM (20 vs. 9, P = 0.03), of which the majority were
                      found in patients who had received RT (17 vs. 3,
                      P = 0.08). None of these isolated SWI blooming artifacts
                      turned into overt metastases over time (median follow-up:
                      8.5 months). Similar findings persisted as remnants of
                      successfully treated metastases $(88\%;$ 7/8).We conclude
                      that SWI provides little additional diagnostic benefit over
                      standard T1 -weighted imaging, as melanin content alone does
                      not cause diagnostically relevant SWI blooming. Signal
                      transition of SWI may rather indicate secondary phenomena
                      like microbleeding and/or metal scavenging. Our results
                      suggest that isolated SWI artifacts do not constitute vital
                      tumor tissue but represent unspecific microbleedings,
                      RT-related parenchymal changes or posttherapeutic remnants
                      of former metastatic lesions.3 Technical Efficacy Stage: 5
                      J. Magn. Reson. Imaging 2019;50:1251-1259.},
      cin          = {E010 / D170 / C060 / B320 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)D170-20160331 /
                      I:(DE-He78)C060-20160331 / I:(DE-He78)B320-20160331 /
                      I:(DE-He78)L101-20160331},
      pnm          = {314 - Tumor immunology (POF3-314)},
      pid          = {G:(DE-HGF)POF3-314},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30793419},
      doi          = {10.1002/jmri.26692},
      url          = {https://inrepo02.dkfz.de/record/147217},
}