{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:40:20Z","timestamp":1792737620699,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glioblastoma (GBM) is characterized by intra\u2010tumoral heterogeneity, rapid proliferation, hypoxia\u2010driven radio\u2010resistance, and early recurrence. Gadolinium\u2010Enhanced MRI, the standard of care imaging modality for surgical and radiotherapy planning, lacks specificity for viable tumor burden, particularly in non\u2010enhancing regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      This pilot study aimed to evaluate whether preoperative dual\u2010tracer PET using a combined dose of\n                      <jats:sup>18<\/jats:sup>\n                      FMISO (hypoxia) and\n                      <jats:sup>18<\/jats:sup>\n                      FLT (proliferation) improves tumor delineation and predicts subsequent local recurrence compared with MRI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seven patients with WHO grade 4 gliomas (5 GBM, 2 IDH\u2010mutant astrocytomas) underwent preoperative dual\u2010[FMISO+FLT] static PET at 180\u00a0min post\u2010injection, and MRI. 6\/7 patients underwent resection. Tumor volumes were segmented from PET, contrast\u2010enhanced T1 (T1\u2010Gd), and T2\u2010FLAIR. Postoperative resection cavities were delineated, and follow\u2010up MRI every 3 months was used to identify recurrence. PET\u2010defined tumor volumes extending beyond resection were correlated with subsequent recurrence sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen lesions were analyzed; all showed [FMISO+FLT] uptake (mean activity concentration ratio 1.6 with the cerebellar cortex used as reference region). PET\u2010defined tumor volumes (9.2 cc) were slightly larger than T1\u2010Gd (7.9 cc) but smaller than T2\u2010FLAIR (28.8 cc). PET\u2010defined volumes frequently extended beyond MRI\u2010defined contours (mean non\u2010overlap 6.4 cc vs T1\u2010Gd; 1.5 cc vs. T2\u2010FLAIR). Of six patients undergoing resection, four developed local recurrence within 3.3 months. In all cases, recurrence arose within PET\u2010avid regions outside the resection cavity. The other two patients with complete resection of PET\u2010defined volumes showed a relatively prolonged progression\u2010free\u2010survival (PFS) and including one patient with overall survival exceeding 36 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dual\u2010[FMISO+FLT] PET is feasible, safe, and can allow delineation of biologically viable tumor subregions, in particular within the MRI T2\u2010FLAIR volume. This approach prospectively identified sites of subsequent local recurrence and may improve surgical planning and radiotherapy dose escalation. Larger validation studies are warranted to establish dual\u2010tracer PET as a precision imaging paradigm in GBM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.70683","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:48:51Z","timestamp":1792666131000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined PET imaging of tumor hypoxia and proliferation in Glioblastoma using a single injection of 18F\u2010FMISO and 18F\u2010FLT: Association with sites of subsequent recurrence"],"prefix":"10.1002","volume":"53","author":[{"given":"Chang","family":"Cui","sequence":"first","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Magge","sequence":"additional","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Liechty","sequence":"additional","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Guhlke","sequence":"additional","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Burnazi","sequence":"additional","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Calimag","sequence":"additional","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Ramakrishna","sequence":"additional","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jazmin","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Radiology Department Long Island Jewish Hospital  Long Island New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arindam","family":"RoyChoudhury","sequence":"additional","affiliation":[{"name":"Radiology Department Weill Cornell Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Ramon F","family":"Barajas","sequence":"additional","affiliation":[{"name":"Radiology Department Oregon Health &amp; 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