Figure 6

Benefit of biparametric analysis of DWI- and FET PET-derived parameters compared to conventional clinical evaluation. Semi-automated delineation (IC80) of lesion VOI based on PET (a) was transferred to the respective ADC map (b). The following panels show post-contrast T1W (c) and a 3D lesion model (d) for illustration. Labels on the most right show conventional clinical assessment. First row (α) shows a patient with PTRE, which was originally classified as glioma recurrence, which led to surgical intervention. Second row (β) shows a case with an inconclusive clinical evaluation, which was later shown to be glioma relapse. The following rows (γ, δ) present patients with relapse according to histopathology, originally classified as treatment-related changes. Clinical assessment would have benefitted from biparametric analysis using TBRmax (TBRmax > 2) and ADCmean (ADCmean > 1254), reducing clinical false positive and negative classification.