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<meta name="HW.identifier" content="/ajnr/38/3/485.atom" />
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<meta name="DC.Title" content="Diagnostic Accuracy of T1-Weighted Dynamic Contrast-Enhanced–MRI and DWI-ADC for Differentiation of Glioblastoma and Primary CNS Lymphoma" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5023" />
<meta name="DC.Date" content="2017-03-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2017 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Glioblastoma and primary CNS lymphoma dictate different neurosurgical strategies; it is critical to distinguish them preoperatively. However, current imaging modalities do not effectively differentiate them. We aimed to examine the use of DWI and T1-weighted dynamic contrast-enhanced–MR imaging as potential discriminative tools.

MATERIALS AND METHODS: We retrospectively reviewed 18 patients with primary CNS lymphoma and 36 matched patients with glioblastoma with pretreatment DWI and dynamic contrast-enhanced–MR imaging. VOIs were drawn around the tumor on contrast-enhanced T1WI and FLAIR images; these images were transferred onto coregistered ADC maps to obtain the ADC and onto dynamic contrast-enhanced perfusion maps to obtain the plasma volume and permeability transfer constant. Histogram analysis was performed to determine the mean and relative ADCmean and relative 90th percentile values for plasma volume and the permeability transfer constant. Nonparametric tests were used to assess differences, and receiver operating characteristic analysis was performed for optimal threshold calculations.

RESULTS: The enhancing component of primary CNS lymphoma was found to have significantly lower ADCmean (1.1 × 10−3 versus 1.4 × 10−3; P &lt; .001) and relative ADCmean (1.5 versus 1.9; P &lt; .001) and relative 90th percentile values for plasma volume (3.7 versus 5.0; P &lt; .05) than the enhancing component of glioblastoma, but not significantly different relative 90th percentile values for the permeability transfer constant (5.4 versus 4.4; P = .83). The nonenhancing portions of glioblastoma and primary CNS lymphoma did not differ in these parameters. On the basis of receiver operating characteristic analysis, mean ADC provided the best threshold (area under the curve = 0.83) to distinguish primary CNS lymphoma from glioblastoma, which was not improved with normalized ADC or the addition of perfusion parameters.

CONCLUSIONS: ADC was superior to dynamic contrast-enhanced–MR imaging perfusion, alone or in combination, in differentiating primary CNS lymphoma from glioblastoma.

AUC
:   area under the curve
DCE
:   dynamic contrast-enhanced
-5%tile
:   5th percentile
GBM
:   glioblastoma
K trans
:   permeability transfer constant
MGMT 
:   O(6)-methylguanin-DNA-methyltransferase 
-90%tile
:   90th percentile
PCNSL
:   primary CNS lymphoma
r-
:   relative or normalized
Ve
:   extravascular extracellular volume
Vp
:   blood plasma volume" />
<meta name="DC.Contributor" content="X. Lin" />
<meta name="DC.Contributor" content="M. Lee" />
<meta name="DC.Contributor" content="O. Buck" />
<meta name="DC.Contributor" content="K.M. Woo" />
<meta name="DC.Contributor" content="Z. Zhang" />
<meta name="DC.Contributor" content="V. Hatzoglou" />
<meta name="DC.Contributor" content="A. Omuro" />
<meta name="DC.Contributor" content="J. Arevalo-Perez" />
<meta name="DC.Contributor" content="A.A. Thomas" />
<meta name="DC.Contributor" content="J. Huse" />
<meta name="DC.Contributor" content="K. Peck" />
<meta name="DC.Contributor" content="A.I. Holodny" />
<meta name="DC.Contributor" content="R.J. Young" />
<meta name="article:published_time" content="2017-03-01" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="Diagnostic Accuracy of T1-Weighted Dynamic Contrast-Enhanced–MRI and DWI-ADC for Differentiation of Glioblastoma and Primary CNS Lymphoma" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Glioblastoma and primary CNS lymphoma dictate different neurosurgical strategies; it is critical to distinguish them preoperatively. However, current imaging modalities do not effectively differentiate them. We aimed to examine the use of DWI and T1-weighted dynamic contrast-enhanced–MR imaging as potential discriminative tools.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We retrospectively reviewed 18 patients with primary CNS lymphoma and 36 matched patients with glioblastoma with pretreatment DWI and dynamic contrast-enhanced–MR imaging. VOIs were drawn around the tumor on contrast-enhanced T1WI and FLAIR images; these images were transferred onto coregistered ADC maps to obtain the ADC and onto dynamic contrast-enhanced perfusion maps to obtain the plasma volume and permeability transfer constant. Histogram analysis was performed to determine the mean and relative ADC&lt;sub&gt;mean&lt;/sub&gt; and relative 90th percentile values for plasma volume and the permeability transfer constant. Nonparametric tests were used to assess differences, and receiver operating characteristic analysis was performed for optimal threshold calculations.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The enhancing component of primary CNS lymphoma was found to have significantly lower ADC&lt;sub&gt;mean&lt;/sub&gt; (1.1 × 10&lt;sup&gt;−3&lt;/sup&gt; versus 1.4 × 10&lt;sup&gt;−3&lt;/sup&gt;; &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) and relative ADC&lt;sub&gt;mean&lt;/sub&gt; (1.5 versus 1.9; &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) and relative 90th percentile values for plasma volume (3.7 versus 5.0; &lt;i&gt;P&lt;/i&gt; &amp;lt; .05) than the enhancing component of glioblastoma, but not significantly different relative 90th percentile values for the permeability transfer constant (5.4 versus 4.4; &lt;i&gt;P&lt;/i&gt; = .83). The nonenhancing portions of glioblastoma and primary CNS lymphoma did not differ in these parameters. On the basis of receiver operating characteristic analysis, mean ADC provided the best threshold (area under the curve = 0.83) to distinguish primary CNS lymphoma from glioblastoma, which was not improved with normalized ADC or the addition of perfusion parameters.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;ADC was superior to dynamic contrast-enhanced–MR imaging perfusion, alone or in combination, in differentiating primary CNS lymphoma from glioblastoma.&lt;/p&gt;" />
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<meta name="twitter:title" content="Diagnostic Accuracy of T1-Weighted Dynamic Contrast-Enhanced–MRI and DWI-ADC for Differentiation of Glioblastoma and Primary CNS Lymphoma" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Glioblastoma and primary CNS lymphoma dictate different neurosurgical strategies; it is critical to distinguish them preoperatively. However, current imaging modalities do not effectively differentiate them. We aimed to examine the use of DWI and T1-weighted dynamic contrast-enhanced–MR imaging as potential discriminative tools.

MATERIALS AND METHODS: We retrospectively reviewed 18 patients with primary CNS lymphoma and 36 matched patients with glioblastoma with pretreatment DWI and dynamic contrast-enhanced–MR imaging. VOIs were drawn around the tumor on contrast-enhanced T1WI and FLAIR images; these images were transferred onto coregistered ADC maps to obtain the ADC and onto dynamic contrast-enhanced perfusion maps to obtain the plasma volume and permeability transfer constant. Histogram analysis was performed to determine the mean and relative ADCmean and relative 90th percentile values for plasma volume and the permeability transfer constant. Nonparametric tests were used to assess differences, and receiver operating characteristic analysis was performed for optimal threshold calculations.

RESULTS: The enhancing component of primary CNS lymphoma was found to have significantly lower ADCmean (1.1 × 10−3 versus 1.4 × 10−3; P &lt; .001) and relative ADCmean (1.5 versus 1.9; P &lt; .001) and relative 90th percentile values for plasma volume (3.7 versus 5.0; P &lt; .05) than the enhancing component of glioblastoma, but not significantly different relative 90th percentile values for the permeability transfer constant (5.4 versus 4.4; P = .83). The nonenhancing portions of glioblastoma and primary CNS lymphoma did not differ in these parameters. On the basis of receiver operating characteristic analysis, mean ADC provided the best threshold (area under the curve = 0.83) to distinguish primary CNS lymphoma from glioblastoma, which was not improved with normalized ADC or the addition of perfusion parameters.

CONCLUSIONS: ADC was superior to dynamic contrast-enhanced–MR imaging perfusion, alone or in combination, in differentiating primary CNS lymphoma from glioblastoma.

AUC
:   area under the curve
DCE
:   dynamic contrast-enhanced
-5%tile
:   5th percentile
GBM
:   glioblastoma
K trans
:   permeability transfer constant
MGMT 
:   O(6)-methylguanin-DNA-methyltransferase 
-90%tile
:   90th percentile
PCNSL
:   primary CNS lymphoma
r-
:   relative or normalized
Ve
:   extravascular extracellular volume
Vp
:   blood plasma volume" />
<meta name="og-title" property="og:title" content="Diagnostic Accuracy of T1-Weighted Dynamic Contrast-Enhanced–MRI and DWI-ADC for Differentiation of Glioblastoma and Primary CNS Lymphoma" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/38/3/485" />
<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: Glioblastoma and primary CNS lymphoma dictate different neurosurgical strategies; it is critical to distinguish them preoperatively. However, current imaging modalities do not effectively differentiate them. We aimed to examine the use of DWI and T1-weighted dynamic contrast-enhanced–MR imaging as potential discriminative tools.

MATERIALS AND METHODS: We retrospectively reviewed 18 patients with primary CNS lymphoma and 36 matched patients with glioblastoma with pretreatment DWI and dynamic contrast-enhanced–MR imaging. VOIs were drawn around the tumor on contrast-enhanced T1WI and FLAIR images; these images were transferred onto coregistered ADC maps to obtain the ADC and onto dynamic contrast-enhanced perfusion maps to obtain the plasma volume and permeability transfer constant. Histogram analysis was performed to determine the mean and relative ADCmean and relative 90th percentile values for plasma volume and the permeability transfer constant. Nonparametric tests were used to assess differences, and receiver operating characteristic analysis was performed for optimal threshold calculations.

RESULTS: The enhancing component of primary CNS lymphoma was found to have significantly lower ADCmean (1.1 × 10−3 versus 1.4 × 10−3; P &lt; .001) and relative ADCmean (1.5 versus 1.9; P &lt; .001) and relative 90th percentile values for plasma volume (3.7 versus 5.0; P &lt; .05) than the enhancing component of glioblastoma, but not significantly different relative 90th percentile values for the permeability transfer constant (5.4 versus 4.4; P = .83). The nonenhancing portions of glioblastoma and primary CNS lymphoma did not differ in these parameters. On the basis of receiver operating characteristic analysis, mean ADC provided the best threshold (area under the curve = 0.83) to distinguish primary CNS lymphoma from glioblastoma, which was not improved with normalized ADC or the addition of perfusion parameters.

CONCLUSIONS: ADC was superior to dynamic contrast-enhanced–MR imaging perfusion, alone or in combination, in differentiating primary CNS lymphoma from glioblastoma.

AUC
:   area under the curve
DCE
:   dynamic contrast-enhanced
-5%tile
:   5th percentile
GBM
:   glioblastoma
K trans
:   permeability transfer constant
MGMT 
:   O(6)-methylguanin-DNA-methyltransferase 
-90%tile
:   90th percentile
PCNSL
:   primary CNS lymphoma
r-
:   relative or normalized
Ve
:   extravascular extracellular volume
Vp
:   blood plasma volume" />
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    <title>Diagnostic Accuracy of T1-Weighted Dynamic Contrast-Enhanced–MRI and DWI-ADC for Differentiation of Glioblastoma and Primary CNS Lymphoma | American Journal of Neuroradiology</title>  
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14693--5" data-node-nid="14693" id="top-node-14693--6127878510" data-pisa="ajnr;38/3/485" data-pisa-master="ajnr;ajnr.A5023" data-apath="/ajnr/38/3/485.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">ADULT BRAIN</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Diagnostic Accuracy of T1-Weighted Dynamic Contrast-Enhanced–MRI and DWI-ADC for Differentiation of Glioblastoma and Primary CNS Lymphoma</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">X. Lin</span>, <span class="highwire-citation-author" data-delta="1">M. Lee</span>, <span class="highwire-citation-author" data-delta="2">O. Buck</span>, <span class="highwire-citation-author" data-delta="3">K.M. Woo</span>, <span class="highwire-citation-author" data-delta="4">Z. Zhang</span>, <span class="highwire-citation-author" data-delta="5">V. Hatzoglou</span>, <span class="highwire-citation-author" data-delta="6">A. Omuro</span>, <span class="highwire-citation-author" data-delta="7">J. Arevalo-Perez</span>, <span class="highwire-citation-author" data-delta="8">A.A. Thomas</span>, <span class="highwire-citation-author" data-delta="9">J. Huse</span>, <span class="highwire-citation-author" data-delta="10">K. Peck</span>, <span class="highwire-citation-author" data-delta="11">A.I. Holodny</span> and <span class="highwire-citation-author" data-delta="12">R.J. Young</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">March 2017,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">485-491; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5023 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14693--6127878510" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">X. Lin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neurology (X.L., A.O., A.A.T.)</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Neurology (X.L.), National Neuroscience Institute, Singapore.</div></span></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=X.%2BLin%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=Lin%20X&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"><a href="/search/author1%3AX.%2BLin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9551-7659" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. Lin</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. Lee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (M.L., O.B., V.H., J.A.-P., A.I.H., R.J.Y.)</div></span></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=M.%2BLee%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=Lee%20M&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"><a href="/search/author1%3AM.%2BLee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-4288-3238" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Lee</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">O. Buck </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (M.L., O.B., V.H., J.A.-P., A.I.H., R.J.Y.)</div></span></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=O.%2BBuck%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=Buck%20O&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"><a href="/search/author1%3AO.%2BBuck%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-2448-1537" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for O. Buck</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">K.M. Woo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Epidemiology and Biostatistics (K.M.W., Z.Z.)</div></span></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=K.M.%2BWoo%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=Woo%20K&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"><a href="/search/author1%3AK.M.%2BWoo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-4730-0321" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K.M. Woo</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Z. Zhang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Epidemiology and Biostatistics (K.M.W., Z.Z.)</div></span></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=Z.%2BZhang%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=Zhang%20Z&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"><a href="/search/author1%3AZ.%2BZhang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-1556-7945" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Z. Zhang</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">V. Hatzoglou </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (M.L., O.B., V.H., J.A.-P., A.I.H., R.J.Y.)</div><div class='author-affiliation'><span class='nlm-sup'>f</span>The Brain Tumor Center (V.H., A.O., A.I.H., R.J.Y.), Memorial Sloan Kettering Cancer Center, New York, New York</div></span></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=V.%2BHatzoglou%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=Hatzoglou%20V&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"><a href="/search/author1%3AV.%2BHatzoglou%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-0252-0694" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for V. Hatzoglou</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">A. Omuro </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neurology (X.L., A.O., A.A.T.)</div><div class='author-affiliation'><span class='nlm-sup'>f</span>The Brain Tumor Center (V.H., A.O., A.I.H., R.J.Y.), Memorial Sloan Kettering Cancer Center, New York, New York</div></span></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=A.%2BOmuro%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=Omuro%20A&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"><a href="/search/author1%3AA.%2BOmuro%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-4299-3664" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Omuro</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">J. Arevalo-Perez </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (M.L., O.B., V.H., J.A.-P., A.I.H., R.J.Y.)</div></span></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=J.%2BArevalo-Perez%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=Arevalo-Perez%20J&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"><a href="/search/author1%3AJ.%2BArevalo-Perez%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-6283-0558" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. 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Thomas </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neurology (X.L., A.O., A.A.T.)</div></span></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=A.A.%2BThomas%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=Thomas%20A&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"><a href="/search/author1%3AA.A.%2BThomas%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-2397-736X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.A. Thomas</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">J. Huse </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Pathology (J.H.)</div></span></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=J.%2BHuse%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=Huse%20J&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"><a href="/search/author1%3AJ.%2BHuse%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-4440-3250" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Huse</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">K. Peck </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Medical Physics (K.P.)</div></span></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=K.%2BPeck%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=Peck%20K&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"><a href="/search/author1%3AK.%2BPeck%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9841-3078" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. 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Holodny </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (M.L., O.B., V.H., J.A.-P., A.I.H., R.J.Y.)</div><div class='author-affiliation'><span class='nlm-sup'>f</span>The Brain Tumor Center (V.H., A.O., A.I.H., R.J.Y.), Memorial Sloan Kettering Cancer Center, New York, New York</div></span></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=A.I.%2BHolodny%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=Holodny%20A&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"><a href="/search/author1%3AA.I.%2BHolodny%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-1159-2705" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.I. Holodny</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">R.J. Young </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Radiology (M.L., O.B., V.H., J.A.-P., A.I.H., R.J.Y.)</div><div class='author-affiliation'><span class='nlm-sup'>f</span>The Brain Tumor Center (V.H., A.O., A.I.H., R.J.Y.), Memorial Sloan Kettering Cancer Center, New York, New York</div></span></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.J.%2BYoung%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=Young%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"><a href="/search/author1%3AR.J.%2BYoung%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-7003-3017" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R.J. 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          <a href="/content/38/3" class="highwire-cite-linked-title" data-icon-position="" data-hide-link-title="0"><span class="highwire-cite-title">American Journal of Neuroradiology</span></a>      
      
        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 38</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 3 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Mar 2017 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Lin</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">O.</span> <span class="nlm-surname">Buck</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">K.M.</span> <span class="nlm-surname">Woo</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Z.</span> <span class="nlm-surname">Zhang</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Hatzoglou</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Omuro</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Arevalo-Perez</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.A.</span> <span class="nlm-surname">Thomas</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Huse</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Peck</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">A.I.</span> <span class="nlm-surname">Holodny</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">R.J.</span> <span class="nlm-surname">Young</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">Mar 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">485-491; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5023 </span></div>
  
  
  
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    	<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">Mar 2017, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">38 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">485-491; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5023 </span></div>
  
  
  
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