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@ARTICLE{Stock:298955,
      author       = {A. Stock and J. Krumma and G. Fleischhack and S. Tippelt
                      and L. Rink and T. Pietsch and M. Mynarek and D.
                      Obrecht-Sturm and S. Rutkowski and S. Pfister$^*$ and D.
                      Sturm$^*$ and K. Pajtler$^*$ and U. Schüller and B.
                      Timmermann$^*$ and R.-D. Kortmann and B. Bison and M. Pham
                      and M. Warmuth-Metz},
      title        = {{R}ecurrence patterns in pediatric intracranial ependymal
                      neoplasm: a systematic imaging work-up.},
      journal      = {Neuroradiology},
      volume       = {67},
      number       = {3},
      issn         = {0028-3940},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2025-00389},
      pages        = {767-781},
      year         = {2025},
      note         = {2025 Mar;67(3):767-781},
      abstract     = {Currently, the different types of ependymal neoplasm (EPN)
                      are defined by anatomical localization and genetics. This
                      retrospective multicenter study aimed to analyze the imaging
                      patterns of both local and distant recurrences in
                      supratentorial (ST) and posterior fossa (PF) EPN.We
                      exclusively evaluated patients with recurrent EPN. To form
                      the basis for follow-up evaluations the imaging
                      characteristics for ST-EPN and PF-EPN were assessed and
                      compared to each other. Follow-up assessments included the
                      idenTIFFication of local recurrent tumors, leptomeningeal
                      dissemination, secondary intraparenchymal lesions, and
                      extraneural metastases. MR-signal characteristics of local
                      recurrent tumors were compared to the primary tumor.The
                      imaging series included 73 patients (median age at diagnosis
                      4.6 years; 56 PF-EPN). Recurrences were observed at up to
                      five time points, with a total of 145 recurrence events
                      documented. At first recurrence most PF-EPN recurred locally
                      (29/56), while ST-EPN relapsed by intracranial dissemination
                      (9/17). Local recurrent tumor grew fast and differed in up
                      to one-fifth from the primary $(13.2\%$ lower T2-signal,
                      $14.6\%$ brighter T1-signal, $19\%$ less
                      contrast-enhancement). Leptomeningeal dissemination in
                      ST-EPN is mainly restricted to intracranial $(90.5\%)$ while
                      PF-EPN more frequently present with spinal spread
                      $(45.7\%).$ Transient post-radiogenic lesions (n = 2) and
                      secondary malignancies (n = 2) were rare. Extraneural
                      metastases (n = 3) were found mainly near the surgical
                      access.Recurrences can occur multiple times in EPN patients,
                      and the recurrence patterns differ between ST-EPN and
                      PF-EPN. Imaging characteristics of local recurrences can
                      differ from the primary tumor which is crucial for accurate
                      diagnosis and treatment planning.},
      keywords     = {Child (Other) / Ependymoma (Other) / Magnetic resonance
                      imaging (Other) / Neoplasm metastasis (Other) / Recurrence
                      (Other)},
      cin          = {B062 / B360 / HD01 / ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)B062-20160331 / I:(DE-He78)B360-20160331 /
                      I:(DE-He78)HD01-20160331 / I:(DE-He78)ED01-20160331},
      pnm          = {312 - Funktionelle und strukturelle Genomforschung
                      (POF4-312)},
      pid          = {G:(DE-HGF)POF4-312},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39960531},
      doi          = {10.1007/s00234-025-03553-w},
      url          = {https://inrepo02.dkfz.de/record/298955},
}