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<!DOCTYPE html>
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<meta name="HW.identifier" content="/ajnr/early/2017/09/07/ajnr.A5368.atom" />
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<meta name="DC.Title" content="Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5368" />
<meta name="DC.Date" content="2017-09-07" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2017 American Society of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.

PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.

DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.

STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.

DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.

DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and 11C methionine–PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.

LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.

CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.

### Abbreviations

hsROC
:   hierarchic summary receiver operating characteristic
ROC
:   receiver operating characteristic
STARD
:   Standard for Reporting of Diagnostic Accuracy
CI
:   credibility interval
TP
:   true-positive
TN
:   true-negative
FP
:   false-positive
FN
:   false-negative" />
<meta name="DC.Contributor" content="N. Verburg" />
<meta name="DC.Contributor" content="F.W.A. Hoefnagels" />
<meta name="DC.Contributor" content="F. Barkhof" />
<meta name="DC.Contributor" content="R. Boellaard" />
<meta name="DC.Contributor" content="S. Goldman" />
<meta name="DC.Contributor" content="J. Guo" />
<meta name="DC.Contributor" content="J.J. Heimans" />
<meta name="DC.Contributor" content="O.S. Hoekstra" />
<meta name="DC.Contributor" content="R. Jain" />
<meta name="DC.Contributor" content="M. Kinoshita" />
<meta name="DC.Contributor" content="P.J.W. Pouwels" />
<meta name="DC.Contributor" content="S.J. Price" />
<meta name="DC.Contributor" content="J.C. Reijneveld" />
<meta name="DC.Contributor" content="A. Stadlbauer" />
<meta name="DC.Contributor" content="W.P. Vandertop" />
<meta name="DC.Contributor" content="P. Wesseling" />
<meta name="DC.Contributor" content="A.H. Zwinderman" />
<meta name="DC.Contributor" content="P.C. De Witt Hamer" />
<meta name="article:published_time" content="2017-09-07" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND:&lt;/h3&gt;
&lt;p&gt;Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.&lt;/p&gt;&lt;h3&gt;PURPOSE:&lt;/h3&gt;
&lt;p&gt;In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.&lt;/p&gt;&lt;h3&gt;DATA SOURCES:&lt;/h3&gt;
&lt;p&gt;We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.&lt;/p&gt;&lt;h3&gt;STUDY SELECTION:&lt;/h3&gt;
&lt;p&gt;Study inclusion was based on quality criteria. Individual patient data were used, if available.&lt;/p&gt;&lt;h3&gt;DATA ANALYSIS:&lt;/h3&gt;
&lt;p&gt;A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.&lt;/p&gt;&lt;h3&gt;DATA SYNTHESIS:&lt;/h3&gt;
&lt;p&gt;Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and &lt;sup&gt;11&lt;/sup&gt;C methionine–PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.&lt;/p&gt;&lt;h3&gt;LIMITATIONS:&lt;/h3&gt;
&lt;p&gt;True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.&lt;/p&gt;" />
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<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-4879-0457" />
<meta name="citation_author" content="M. Kinoshita" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-7923-6902" />
<meta name="citation_author" content="P.J.W. Pouwels" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-8430-0606" />
<meta name="citation_author" content="S.J. Price" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-7535-3009" />
<meta name="citation_author" content="J.C. Reijneveld" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-2257-3147" />
<meta name="citation_author" content="A. Stadlbauer" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-8348-2620" />
<meta name="citation_author" content="W.P. Vandertop" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-5417-0265" />
<meta name="citation_author" content="P. Wesseling" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0001-5453-5201" />
<meta name="citation_author" content="A.H. Zwinderman" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0003-0361-3139" />
<meta name="citation_author" content="P.C. De Witt Hamer" />
<meta name="citation_author_institution" content="From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0003-2988-8544" />
<meta name="twitter:title" content="Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.

PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.

DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.

STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.

DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.

DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and 11C methionine–PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.

LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.

CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.

### Abbreviations

hsROC
:   hierarchic summary receiver operating characteristic
ROC
:   receiver operating characteristic
STARD
:   Standard for Reporting of Diagnostic Accuracy
CI
:   credibility interval
TP
:   true-positive
TN
:   true-negative
FP
:   false-positive
FN
:   false-negative" />
<meta name="og-title" property="og:title" content="Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2017/09/07/ajnr.A5368" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND: Brain imaging in diffuse glioma is used for diagnosis, treatment planning, and follow-up.

PURPOSE: In this meta-analysis, we address the diagnostic accuracy of imaging to delineate diffuse glioma.

DATA SOURCES: We systematically searched studies of adults with diffuse gliomas and correlation of imaging with histopathology.

STUDY SELECTION: Study inclusion was based on quality criteria. Individual patient data were used, if available.

DATA ANALYSIS: A hierarchic summary receiver operating characteristic method was applied. Low- and high-grade gliomas were analyzed in subgroups.

DATA SYNTHESIS: Sixty-one studies described 3532 samples in 1309 patients. The mean Standard for Reporting of Diagnostic Accuracy score (13/25) indicated suboptimal reporting quality. For diffuse gliomas as a whole, the diagnostic accuracy was best with T2-weighted imaging, measured as area under the curve, false-positive rate, true-positive rate, and diagnostic odds ratio of 95.6%, 3.3%, 82%, and 152. For low-grade gliomas, the diagnostic accuracy of T2-weighted imaging as a reference was 89.0%, 0.4%, 44.7%, and 205; and for high-grade gliomas, with T1-weighted gadolinium-enhanced MR imaging as a reference, it was 80.7%, 16.8%, 73.3%, and 14.8. In high-grade gliomas, MR spectroscopy (85.7%, 35.0%, 85.7%, and 12.4) and 11C methionine–PET (85.1%, 38.7%, 93.7%, and 26.6) performed better than the reference imaging.

LIMITATIONS: True-negative samples were underrepresented in these data, so false-positive rates are probably less reliable than true-positive rates. Multimodality imaging data were unavailable.

CONCLUSIONS: The diagnostic accuracy of commonly used imaging is better for delineation of low-grade gliomas than high-grade gliomas on the basis of limited evidence. Improvement is indicated from advanced techniques, such as MR spectroscopy and PET.

### Abbreviations

hsROC
:   hierarchic summary receiver operating characteristic
ROC
:   receiver operating characteristic
STARD
:   Standard for Reporting of Diagnostic Accuracy
CI
:   credibility interval
TP
:   true-positive
TN
:   true-negative
FP
:   false-positive
FN
:   false-negative" />
<meta name="og-type" property="og:type" content="article" />
<meta name="og-image" property="og:image" content="" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node56080--5" data-node-nid="56080" id="top-node-56080--6579695400" data-pisa="ajnr;ajnr.A5368v1" data-pisa-master="ajnr;ajnr.A5368" data-apath="/ajnr/early/2017/09/07/ajnr.A5368.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 highwire-citation-access-check" data-pisa-id="ajnr;ajnr.A5368" data-atom-uri="/ajnr/early/2017/09/07/ajnr.A5368.atom" data-request-view="full"></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Diagnostic Accuracy of Neuroimaging to Delineate Diffuse Gliomas within the Brain: A Meta-Analysis</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">N. Verburg</span>, <span class="highwire-citation-author" data-delta="1">F.W.A. Hoefnagels</span>, <span class="highwire-citation-author" data-delta="2">F. Barkhof</span>, <span class="highwire-citation-author" data-delta="3">R. Boellaard</span>, <span class="highwire-citation-author" data-delta="4">S. Goldman</span>, <span class="highwire-citation-author" data-delta="5">J. Guo</span>, <span class="highwire-citation-author" data-delta="6">J.J. Heimans</span>, <span class="highwire-citation-author" data-delta="7">O.S. Hoekstra</span>, <span class="highwire-citation-author" data-delta="8">R. Jain</span>, <span class="highwire-citation-author" data-delta="9">M. Kinoshita</span>, <span class="highwire-citation-author" data-delta="10">P.J.W. Pouwels</span>, <span class="highwire-citation-author" data-delta="11">S.J. Price</span>, <span class="highwire-citation-author" data-delta="12">J.C. Reijneveld</span>, <span class="highwire-citation-author" data-delta="13">A. Stadlbauer</span>, <span class="highwire-citation-author" data-delta="14">W.P. Vandertop</span>, <span class="highwire-citation-author" data-delta="15">P. Wesseling</span>, <span class="highwire-citation-author" data-delta="16">A.H. Zwinderman</span> and <span class="highwire-citation-author" data-delta="17">P.C. De Witt Hamer</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">September 2017,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5368 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-56080--6579695400" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">N. Verburg </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=N.%2BVerburg%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=Verburg%20N&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%3AN.%2BVerburg%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/0000-0003-1048-1664" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N. Verburg</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">F.W.A. Hoefnagels </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=F.W.A.%2BHoefnagels%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=Hoefnagels%20F&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%3AF.W.A.%2BHoefnagels%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/0000-0002-8626-540X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.W.A. Hoefnagels</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">F. Barkhof </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=F.%2BBarkhof%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=Barkhof%20F&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%3AF.%2BBarkhof%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/0000-0003-3543-3706" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. Barkhof</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">R. Boellaard </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.%2BBoellaard%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=Boellaard%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.%2BBoellaard%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/0000-0002-0313-5686" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Boellaard</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">S. Goldman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=S.%2BGoldman%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=Goldman%20S&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%3AS.%2BGoldman%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/0000-0002-9917-8735" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Goldman</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">J. Guo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.%2BGuo%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=Guo%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.%2BGuo%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/0000-0002-9505-230X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Guo</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">J.J. Heimans </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.J.%2BHeimans%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=Heimans%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.J.%2BHeimans%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/0000-0001-7731-2588" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.J. Heimans</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">O.S. Hoekstra </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.S.%2BHoekstra%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=Hoekstra%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.S.%2BHoekstra%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/0000-0003-0767-2734" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for O.S. Hoekstra</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">R. Jain </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.%2BJain%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=Jain%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.%2BJain%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/0000-0002-4879-0457" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Jain</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">M. Kinoshita </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.%2BKinoshita%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=Kinoshita%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.%2BKinoshita%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/0000-0001-7923-6902" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Kinoshita</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">P.J.W. Pouwels </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=P.J.W.%2BPouwels%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=Pouwels%20P&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%3AP.J.W.%2BPouwels%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/0000-0001-8430-0606" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.J.W. Pouwels</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">S.J. Price </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=S.J.%2BPrice%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=Price%20S&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%3AS.J.%2BPrice%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/0000-0002-7535-3009" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.J. Price</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">J.C. Reijneveld </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.C.%2BReijneveld%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=Reijneveld%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.C.%2BReijneveld%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/0000-0002-2257-3147" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.C. Reijneveld</a></li></ul></div><div class="author-tooltip-13"><div class="author-tooltip-name">A. Stadlbauer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.%2BStadlbauer%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=Stadlbauer%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.%2BStadlbauer%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/0000-0001-8348-2620" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Stadlbauer</a></li></ul></div><div class="author-tooltip-14"><div class="author-tooltip-name">W.P. Vandertop </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=W.P.%2BVandertop%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=Vandertop%20W&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%3AW.P.%2BVandertop%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/0000-0001-5417-0265" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for W.P. Vandertop</a></li></ul></div><div class="author-tooltip-15"><div class="author-tooltip-name">P. Wesseling </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=P.%2BWesseling%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=Wesseling%20P&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%3AP.%2BWesseling%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/0000-0001-5453-5201" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Wesseling</a></li></ul></div><div class="author-tooltip-16"><div class="author-tooltip-name">A.H. Zwinderman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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.H.%2BZwinderman%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=Zwinderman%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.H.%2BZwinderman%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/0000-0003-0361-3139" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.H. Zwinderman</a></li></ul></div><div class="author-tooltip-17"><div class="author-tooltip-name">P.C. De Witt Hamer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Neurosurgical Center Amsterdam (N.V., F.W.A.H., W.P.V., P.C.D.W.H.), and Departments of Radiology and Nuclear Medicine (F.B., R.B., O.S.H.), Neurology (J.J.H., J.C.R.), Physics and Medical Technology (P.J.W.P.), and Pathology (P.W.), VU University Medical Center, Amsterdam, the Netherlands; Service of Nuclear Medicine and PET/Biomedical Cyclotron Unit (S.G.), l'université libre de Bruxelles–Hôpital Erasme, Brussels, Belgium; Shanghai Medical College (J.G.), Fudan University, Shanghai, China; Department of Radiology (R.J.), New York University School of Medicine, New York, New York; Department of Neurosurgery (M.K.), Osaka University Graduate School of Medicine, Osaka, Japan; Academic Neurosurgery Division (S.J.P.), Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge, UK; Department of Neurosurgery (A.S.), University of Erlangen-Nuremberg, Erlangen, Germany; Department of Pathology (P.W.), Radboud University Medical Centre, Nijmegen, the Netherlands; Department of Clinical Epidemiology and Biostatistics (A.H.Z.), Academic Medical Center, University of Amsterdam, the Netherlands; and Institutes of Neurology and Healthcare Engineering (F.B.), University College London, London, UK.</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=P.C.%2BDe%2BWitt%2BHamer%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=De%20Witt%20Hamer%20P&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%3AP.C.%2BDe%2BWitt%2BHamer%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/0000-0003-2988-8544" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.C. De Witt Hamer</a></li></ul></div></div></div>  </div>

  
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