{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:30:04Z","timestamp":1780475404513,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Neoplastic intracerebral hemorrhage (ICH) may be incorrectly identified as non\u2010neoplastic ICH on imaging. Relative perihematomal edema (relPHE) on computed tomography (CT) has been proposed as a marker to discriminate neoplastic from non\u2010neoplastic ICH but has not been externally validated. The purpose of this study was to evaluate the discriminatory power of relPHE in an independent cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 291 patients with acute ICH on CT and follow\u2010up magnetic resonance imaging (MRI) were included in this single\u2010center retrospective study. ICH subjects were dichotomized into non\u2010neoplastic or neoplastic ICH based on the diagnosis on the follow\u2010up MRI. ICH and PHE volumes and density values were derived from semi\u2010manually segmented CT scans. Calculated PHE characteristics for discriminating neoplastic ICH were evaluated using receiver\u2010operating characteristic (ROC) curves. ROC curve\u2010associated cut\u2010offs were calculated and compared between the initial and the validation cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 116 patients (39.86%) with neoplastic ICH and 175 (60.14%) with non\u2010neoplastic ICH were included. Median PHE volumes, relPHE, and relPHE adjusted for hematoma density were significantly higher in subjects with neoplastic ICH (all <jats:italic>p<\/jats:italic> values &lt;0.001). ROC curves for relPHE had an area under the curve (AUC) of 0.72 (95% confidence interval [CI] 0.66\u20130.78) and an AUC of 0.81 (95% CI 0.76\u20130.87) for adjusted relPHE. The cut\u2010offs were identical in the two cohorts, with &gt;0.70 for relPHE and &gt;0.01 for adjusted relPHE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Relative perihematomal edema and adjusted relPHE accurately discriminated neoplastic from non\u2010neoplastic ICH on CT imaging in an external patient cohort. These results confirmed the findings of the initial study and may improve clinical decision making.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15760","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T15:08:35Z","timestamp":1677510515000},"page":"1686-1695","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["External validation of the diagnostic value of perihematomal edema characteristics in neoplastic and non\u2010neoplastic intracerebral hemorrhage"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1137-0643","authenticated-orcid":false,"given":"Jawed","family":"Nawabi","sequence":"first","affiliation":[{"name":"Department of Radiology, Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin, Campus Mitte, Berlin Institute of Health Humboldt\u2010Universit\u00e4t zu Berlin, Freie Universit\u00e4t Berlin  Berlin Germany"},{"name":"Berlin Institute of 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