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We have investigated the diagnostic performance of PET\/CT with 3 tracers, <jats:sup>13<\/jats:sup>N-NH<jats:sub>3<\/jats:sub>, <jats:sup>18<\/jats:sup>F-FDOPA, and <jats:sup>18<\/jats:sup>F-FDG, to identify TuR and TrE in glioma patients following treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Forty-three patients with MR-suspected recurrent glioma were included. The maximum and mean standardized uptake values (SUVmax and SUVmean) of the lesion and the lesion-to-normal grey-matter cortex uptake (L\/G) ratio were obtained from each tracer PET\/CT. TuR or TrE was determined by histopathology or clinical MR follow-up for at least 6\u00a0months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In this cohort, 34 patients were confirmed to have TuR, and 9 patients met the diagnostic standard of TrE. The SUVmax and SUVmean of <jats:sup>13<\/jats:sup>N-NH<jats:sub>3<\/jats:sub> and <jats:sup>18<\/jats:sup>F-FDOPA PET\/CT at TuR lesions were significantly higher compared with normal brain tissue (<jats:sup>13<\/jats:sup>N-NH<jats:sub>3<\/jats:sub> 0.696\u2009\u00b1\u20090.558, 0.625\u2009\u00b1\u20090.507 vs 0.486\u2009\u00b1\u20090.413; <jats:sup>18<\/jats:sup>F-FDOPA 0.455\u2009\u00b1\u20090.518, 0.415\u2009\u00b1\u20090.477 vs 0.194\u2009\u00b1\u20090.203; both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), but there was no significant difference in <jats:sup>18<\/jats:sup>F-FDG (6.918\u2009\u00b1\u20093.190, 6.016\u2009\u00b1\u20092.807 vs 6.356\u2009\u00b1\u20093.104, <jats:italic>P<\/jats:italic>\u2009=\u20090.290 and 0.493). L\/G ratios of <jats:sup>13<\/jats:sup>N-NH<jats:sub>3<\/jats:sub> and <jats:sup>18<\/jats:sup>F-FDOPA were significantly higher in TuR than in TrE group (<jats:sup>13<\/jats:sup>N-NH<jats:sub>3,<\/jats:sub> 1.573\u2009\u00b1\u20090.099 vs 1.025\u2009\u00b1\u20090.128, <jats:italic>P<\/jats:italic>\u2009=\u20090.008; <jats:sup>18<\/jats:sup>F-FDOPA, 2.729\u2009\u00b1\u20090.131 vs 1.514\u2009\u00b1\u20090.141, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The sensitivity, specificity and AUC (area under the curve) by ROC (receiver operating characteristic) analysis were 57.7%, 100% and 0.803, for <jats:sup>13<\/jats:sup>N-NH<jats:sub>3<\/jats:sub>; 84.6%, 100% and 0.938, for <jats:sup>18<\/jats:sup>F-FDOPA; and 80.8%, 100%, and 0.952, for the combination, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our results suggest that although multiple tracer PET\/CT may improve differential diagnosis efficacy, for glioma TuR from TrE, <jats:sup>18<\/jats:sup>F-FDOPA PET-CT is the most reliable. The combination of <jats:sup>18<\/jats:sup>F-FDOPA and <jats:sup>13<\/jats:sup>N-NH<jats:sub>3<\/jats:sub> does not increase the diagnostic efficiency, while <jats:sup>18<\/jats:sup>F-FDG is not worthy for differential diagnosis of glioma TuR and TrE.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-021-00624-1","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T09:29:16Z","timestamp":1622798956000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Identify glioma recurrence and treatment effects with triple-tracer PET\/CT"],"prefix":"10.1186","volume":"21","author":[{"given":"Cong","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingshen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaoyan","family":"Xi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengcheng","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qunying","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Sai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Ke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanfan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanchun","family":"Lv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangsong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6868-9866","authenticated-orcid":false,"given":"Zhongping","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,31]]},"reference":[{"issue":"Suppl 5","key":"624_CR1","doi-asserted-by":"publisher","first-page":"v1","DOI":"10.1093\/neuonc\/noz150","volume":"21","author":"QT Ostrom","year":"2019","unstructured":"Ostrom QT, Cioffi G, Gittleman H, Patil N, Waite K, Kruchko C, et al. 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