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<meta name="DC.Title" content="Potential of Integrated [18F] Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2381" />
<meta name="DC.Date" content="2011-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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Indicates open access to non-subscribers at www.ajnr.org" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: There is a need for improved risk stratification of patients with TIA/stroke and carotid atherosclerosis. The purpose of this study was to prospectively investigate the potential of integrated 18F-FDG PET / MDCT in identifying vulnerable carotid plaques.

MATERIALS AND METHODS: Fifty patients with TIA/stroke with an ipsilateral carotid plaque causing &lt;70% stenosis and a plaque on the contralateral asymptomatic side underwent integrated 18F-FDG PET/MDCT within 36.1 ± 20.0 days (range, 9–95 days) of the last symptoms. Carotid plaque 18F-FDG uptake was measured as both the mean and maximum blood-normalized SUV, known as the TBR. Using MDCT, we assessed volumes of vessel wall and individual plaque components.

RESULTS: Mean TBR was only significantly larger in the ipsilateral plaques of patients who were imaged within 38 days (1.24 ± 0.04 [SE] versus 1.17 ± 0.05, P = .014). This also accounted for maximum TBR (1.53 ± 0.06 versus 1.42 ± 0.06, P = .015). MDCT-assessed vessel wall and LRNC volumes were larger in ipsilateral plaques of all patients (982.3 ± 121.3 versus 811.3 ± 106.6 mm3, P = .016; 164.7 ± 26.1 versus 134.3 ± 35.2 mm3, P = .026, respectively).

CONCLUSIONS: In the present study, 18F-FDG PET only detected significant differences between ipsilateral and contralateral asymptomatic plaques in patients with TIA/stroke who were imaged within 38 days, whereas MDCT detected larger vessel wall and LRNC volumes, regardless of time after symptoms. In view of the substantial overlap in measurements of both sides, it remains to be determined whether the differences we found will be clinically meaningful.

CEA
:   carotid endarterectomy
CV
:   coefficient of variation
18F-FDG
:   [ 18F] fluorodeoxyglucose
ICC
:   intraclass correlation coefficient
LRNC
:   lipid-rich necrotic core
MDCT
:   multidetector row spiral CT
NASCET
:   North American Symptomatic Carotid Endarterectomy Trial
PET
:   positron-emission tomography
SE
:   standard error
SUV
:   standardized uptake value
TBR
:   target-to-background ratio
TIA
:   transient ischemic attack" />
<meta name="DC.Contributor" content="R.M. Kwee" />
<meta name="DC.Contributor" content="M.T.B. Truijman" />
<meta name="DC.Contributor" content="W.H. Mess" />
<meta name="DC.Contributor" content="G.J.J. Teule" />
<meta name="DC.Contributor" content="J.W.M. ter Berg" />
<meta name="DC.Contributor" content="C.L. Franke" />
<meta name="DC.Contributor" content="A.G.G.C. Korten" />
<meta name="DC.Contributor" content="B.J. Meems" />
<meta name="DC.Contributor" content="M.H. Prins" />
<meta name="DC.Contributor" content="J.M.A. van Engelshoven" />
<meta name="DC.Contributor" content="J. E. Wildberger" />
<meta name="DC.Contributor" content="R.J. van Oostenbrugge" />
<meta name="DC.Contributor" content="M.E. Kooi" />
<meta name="article:published_time" content="2011-05-01" />
<meta name="article:section" content="Head and Neck" />
<meta name="citation_title" content="Potential of Integrated [18F] Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;There is a need for improved risk stratification of patients with TIA/stroke and carotid atherosclerosis. The purpose of this study was to prospectively investigate the potential of integrated &lt;sup&gt;18&lt;/sup&gt;F-FDG PET&lt;b&gt;/&lt;/b&gt;MDCT in identifying vulnerable carotid plaques.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Fifty patients with TIA/stroke with an ipsilateral carotid plaque causing &amp;lt;70% stenosis and a plaque on the contralateral asymptomatic side underwent integrated &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/MDCT within 36.1 ± 20.0 days (range, 9–95 days) of the last symptoms. Carotid plaque &lt;sup&gt;18&lt;/sup&gt;F-FDG uptake was measured as both the mean and maximum blood-normalized SUV, known as the TBR. Using MDCT, we assessed volumes of vessel wall and individual plaque components.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Mean TBR was only significantly larger in the ipsilateral plaques of patients who were imaged within 38 days (1.24 ± 0.04 [SE] versus 1.17 ± 0.05, &lt;i&gt;P&lt;/i&gt; = .014). This also accounted for maximum TBR (1.53 ± 0.06 versus 1.42 ± 0.06, &lt;i&gt;P&lt;/i&gt; = .015). MDCT-assessed vessel wall and LRNC volumes were larger in ipsilateral plaques of all patients (982.3 ± 121.3 versus 811.3 ± 106.6 mm&lt;sup&gt;3&lt;/sup&gt;, &lt;i&gt;P&lt;/i&gt; = .016; 164.7 ± 26.1 versus 134.3 ± 35.2 mm&lt;sup&gt;3&lt;/sup&gt;, &lt;i&gt;P&lt;/i&gt; = .026, respectively).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In the present study, &lt;sup&gt;18&lt;/sup&gt;F-FDG PET only detected significant differences between ipsilateral and contralateral asymptomatic plaques in patients with TIA/stroke who were imaged within 38 days, whereas MDCT detected larger vessel wall and LRNC volumes, regardless of time after symptoms. In view of the substantial overlap in measurements of both sides, it remains to be determined whether the differences we found will be clinically meaningful.&lt;/p&gt;" />
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<meta name="twitter:title" content="Potential of Integrated [18F] Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/32/5.cover.gif" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: There is a need for improved risk stratification of patients with TIA/stroke and carotid atherosclerosis. The purpose of this study was to prospectively investigate the potential of integrated 18F-FDG PET / MDCT in identifying vulnerable carotid plaques.

MATERIALS AND METHODS: Fifty patients with TIA/stroke with an ipsilateral carotid plaque causing &lt;70% stenosis and a plaque on the contralateral asymptomatic side underwent integrated 18F-FDG PET/MDCT within 36.1 ± 20.0 days (range, 9–95 days) of the last symptoms. Carotid plaque 18F-FDG uptake was measured as both the mean and maximum blood-normalized SUV, known as the TBR. Using MDCT, we assessed volumes of vessel wall and individual plaque components.

RESULTS: Mean TBR was only significantly larger in the ipsilateral plaques of patients who were imaged within 38 days (1.24 ± 0.04 [SE] versus 1.17 ± 0.05, P = .014). This also accounted for maximum TBR (1.53 ± 0.06 versus 1.42 ± 0.06, P = .015). MDCT-assessed vessel wall and LRNC volumes were larger in ipsilateral plaques of all patients (982.3 ± 121.3 versus 811.3 ± 106.6 mm3, P = .016; 164.7 ± 26.1 versus 134.3 ± 35.2 mm3, P = .026, respectively).

CONCLUSIONS: In the present study, 18F-FDG PET only detected significant differences between ipsilateral and contralateral asymptomatic plaques in patients with TIA/stroke who were imaged within 38 days, whereas MDCT detected larger vessel wall and LRNC volumes, regardless of time after symptoms. In view of the substantial overlap in measurements of both sides, it remains to be determined whether the differences we found will be clinically meaningful.

CEA
:   carotid endarterectomy
CV
:   coefficient of variation
18F-FDG
:   [ 18F] fluorodeoxyglucose
ICC
:   intraclass correlation coefficient
LRNC
:   lipid-rich necrotic core
MDCT
:   multidetector row spiral CT
NASCET
:   North American Symptomatic Carotid Endarterectomy Trial
PET
:   positron-emission tomography
SE
:   standard error
SUV
:   standardized uptake value
TBR
:   target-to-background ratio
TIA
:   transient ischemic attack" />
<meta name="og-title" property="og:title" content="Potential of Integrated [18F] Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/32/5/950" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: There is a need for improved risk stratification of patients with TIA/stroke and carotid atherosclerosis. The purpose of this study was to prospectively investigate the potential of integrated 18F-FDG PET / MDCT in identifying vulnerable carotid plaques.

MATERIALS AND METHODS: Fifty patients with TIA/stroke with an ipsilateral carotid plaque causing &lt;70% stenosis and a plaque on the contralateral asymptomatic side underwent integrated 18F-FDG PET/MDCT within 36.1 ± 20.0 days (range, 9–95 days) of the last symptoms. Carotid plaque 18F-FDG uptake was measured as both the mean and maximum blood-normalized SUV, known as the TBR. Using MDCT, we assessed volumes of vessel wall and individual plaque components.

RESULTS: Mean TBR was only significantly larger in the ipsilateral plaques of patients who were imaged within 38 days (1.24 ± 0.04 [SE] versus 1.17 ± 0.05, P = .014). This also accounted for maximum TBR (1.53 ± 0.06 versus 1.42 ± 0.06, P = .015). MDCT-assessed vessel wall and LRNC volumes were larger in ipsilateral plaques of all patients (982.3 ± 121.3 versus 811.3 ± 106.6 mm3, P = .016; 164.7 ± 26.1 versus 134.3 ± 35.2 mm3, P = .026, respectively).

CONCLUSIONS: In the present study, 18F-FDG PET only detected significant differences between ipsilateral and contralateral asymptomatic plaques in patients with TIA/stroke who were imaged within 38 days, whereas MDCT detected larger vessel wall and LRNC volumes, regardless of time after symptoms. In view of the substantial overlap in measurements of both sides, it remains to be determined whether the differences we found will be clinically meaningful.

CEA
:   carotid endarterectomy
CV
:   coefficient of variation
18F-FDG
:   [ 18F] fluorodeoxyglucose
ICC
:   intraclass correlation coefficient
LRNC
:   lipid-rich necrotic core
MDCT
:   multidetector row spiral CT
NASCET
:   North American Symptomatic Carotid Endarterectomy Trial
PET
:   positron-emission tomography
SE
:   standard error
SUV
:   standardized uptake value
TBR
:   target-to-background ratio
TIA
:   transient ischemic attack" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node9490--7" data-node-nid="9490" id="top-node-9490--81382381683" data-pisa="ajnr;32/5/950" data-pisa-master="ajnr;ajnr.A2381" data-apath="/ajnr/32/5/950.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Head and Neck</span></span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-series highwire-cite-metadata">E</span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Potential of Integrated [<sup>18</sup>F] Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">R.M. Kwee</span>, <span class="highwire-citation-author" data-delta="1">M.T.B. Truijman</span>, <span class="highwire-citation-author" data-delta="2">W.H. Mess</span>, <span class="highwire-citation-author" data-delta="3">G.J.J. Teule</span>, <span class="highwire-citation-author" data-delta="4">J.W.M. ter Berg</span>, <span class="highwire-citation-author" data-delta="5">C.L. Franke</span>, <span class="highwire-citation-author" data-delta="6">A.G.G.C. Korten</span>, <span class="highwire-citation-author" data-delta="7">B.J. Meems</span>, <span class="highwire-citation-author" data-delta="8">M.H. Prins</span>, <span class="highwire-citation-author" data-delta="9">J.M.A. van Engelshoven</span>, <span class="highwire-citation-author" data-delta="10">J. E. Wildberger</span>, <span class="highwire-citation-author" data-delta="11">R.J. van Oostenbrugge</span> and <span class="highwire-citation-author" data-delta="12">M.E. Kooi</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2011,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">950-954; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2381 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9490--81382381683" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">R.M. Kwee </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.M.%2BKwee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kwee%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.M.%2BKwee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M.T.B. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">R.M. Kwee</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-2"><span class="name">M.T.B. Truijman</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-2" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-3"><span class="name">W.H. Mess</span><a id="xref-aff-2-3" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-4"><span class="name">G.J.J. Teule</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">d</a>, </li><li class="contributor" id="contrib-5"><span class="name">J.W.M. ter Berg</span><a id="xref-aff-7-1" class="xref-aff" href="#aff-7">g</a>, </li><li class="contributor" id="contrib-6"><span class="name">C.L. Franke</span><a id="xref-aff-8-1" class="xref-aff" href="#aff-8">h</a>, </li><li class="contributor" id="contrib-7"><span class="name">A.G.G.C. Korten</span><a id="xref-aff-9-1" class="xref-aff" href="#aff-9">i</a>, </li><li class="contributor" id="contrib-8"><span class="name">B.J. Meems</span><a id="xref-aff-10-1" class="xref-aff" href="#aff-10">j</a>, </li><li class="contributor" id="contrib-9"><span class="name">M.H. Prins</span><a id="xref-aff-2-4" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">e</a>, </li><li class="contributor" id="contrib-10"><span class="name">J.M.A. van Engelshoven</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-5" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-11"><span class="name">J. E. Wildberger</span><a id="xref-aff-1-4" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-6" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-12"><span class="name">R.J. van Oostenbrugge</span><a id="xref-aff-2-7" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-6-1" class="xref-aff" href="#aff-6">f</a> and </li><li class="last" id="contrib-13"><span class="name">M.E. Kooi</span><a id="xref-aff-1-5" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-8" class="xref-aff" href="#aff-2">b</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the Department of Radiology (R.M.K., M.T.B.T., J.M.A.v.E., J.E.W., M.E.K.)</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>Cardiovascular Research Institute Maastricht (R.M.K., M.T.B.T., W.H.M., M.H.P., J.M.A.v.E., J.E.W., R.J.v.O., M.E.K.)</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Departments of Clinical Neurophysiology (W.H.M.)</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>d</sup>Nuclear Medicine (G.J.J.T.)</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>e</sup>Clinical Epidemiology and Medical Technology Assessment (M.H.P.)</address></li><li class="aff"><a id="aff-6" name="aff-6"></a><address><sup>f</sup>Neurology (R.J.v.O.), Maastricht University Medical Center, Maastricht, the Netherlands</address></li><li class="aff"><a id="aff-7" name="aff-7"></a><address><sup>g</sup>Department of Neurology (J.W.M.t.B.), Orbis Medical Center, Sittard, the Netherlands</address></li><li class="aff"><a id="aff-8" name="aff-8"></a><address><sup>h</sup>Department of Neurology (C.L.F.), Atrium Medical Center Parkstad, Heerlen, the Netherlands</address></li><li class="aff"><a id="aff-9" name="aff-9"></a><address><sup>i</sup>Department of Neurology (A.G.G.C.K.), Laurentius Hospital, Roermond, the Netherlands</address></li><li class="aff"><a id="aff-10" name="aff-10"></a><address><sup>j</sup>Department of Neurology (B.J.M.), Vie Curi Medical Center, Venlo, the Netherlands.</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to M.E. Kooi, PhD, <span class="addr-line">Department of Radiology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the Netherlands</span>; e-mail: <span class="em-link"><span class="em-addr">eline.kooi{at}mumc.nl</span></span>
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      <div class="highwire-cite-title">Potential of Integrated [<sup>18</sup>F] Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">R.M.</span> <span class="nlm-surname">Kwee</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.T.B.</span> <span class="nlm-surname">Truijman</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">W.H.</span> <span class="nlm-surname">Mess</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">G.J.J.</span> <span class="nlm-surname">Teule</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">J.W.M.</span> <span class="nlm-surname">ter Berg</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">C.L.</span> <span class="nlm-surname">Franke</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">A.G.G.C.</span> <span class="nlm-surname">Korten</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">B.J.</span> <span class="nlm-surname">Meems</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">M.H.</span> <span class="nlm-surname">Prins</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">J.M.A.</span> <span class="nlm-surname">van Engelshoven</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">J. E.</span> <span class="nlm-surname">Wildberger</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">R.J.</span> <span class="nlm-surname">van Oostenbrugge</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">M.E.</span> <span class="nlm-surname">Kooi</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2011, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">950-954; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2381 </span></div>
  
  
  
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      <div class="highwire-cite-title">Potential of Integrated [<sup>18</sup>F] Fluorodeoxyglucose Positron-Emission Tomography/CT in Identifying Vulnerable Carotid Plaques</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">R.M.</span> <span class="nlm-surname">Kwee</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.T.B.</span> <span class="nlm-surname">Truijman</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">W.H.</span> <span class="nlm-surname">Mess</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">G.J.J.</span> <span class="nlm-surname">Teule</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">J.W.M.</span> <span class="nlm-surname">ter Berg</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">C.L.</span> <span class="nlm-surname">Franke</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">A.G.G.C.</span> <span class="nlm-surname">Korten</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">B.J.</span> <span class="nlm-surname">Meems</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">M.H.</span> <span class="nlm-surname">Prins</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">J.M.A.</span> <span class="nlm-surname">van Engelshoven</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">J. E.</span> <span class="nlm-surname">Wildberger</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">R.J.</span> <span class="nlm-surname">van Oostenbrugge</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">M.E.</span> <span class="nlm-surname">Kooi</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2011, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">950-954; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2381 </span></div>
  
  
  
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