X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Prospective evaluation of whole-body MRI and 18F-FDG PET/MRI in N and M staging of primary breast cancer patients
    Springer Science and Business Media LLC ; 2020
    In:  European Journal of Nuclear Medicine and Molecular Imaging Vol. 47, No. 12 ( 2020-11), p. 2816-2825
    Details
    In: European Journal of Nuclear Medicine and Molecular Imaging, Springer Science and Business Media LLC, Vol. 47, No. 12 ( 2020-11), p. 2816-2825
    Abstract: To evaluate and compare the diagnostic potential of whole-body MRI and whole-body 18 F-FDG PET/MRI for N and M staging in newly diagnosed, histopathologically proven breast cancer. Material and methods A total of 104 patients (age 53.4 ± 12.5) with newly diagnosed, histopathologically proven breast cancer were enrolled in this study prospectively. All patients underwent a whole-body 18 F-FDG PET/MRI. MRI and 18 F-FDG PET/MRI datasets were evaluated separately regarding lesion count, lesion localization, and lesion characterization (malignant/benign) as well as the diagnostic confidence (5-point ordinal scale, 1–5). The N and M stages were assessed according to the eighth edition of the American Joint Committee on Cancer staging manual in MRI datasets alone and in 18 F-FDG PET/MRI datasets, respectively. In the majority of lesions histopathology served as the reference standard. The remaining lesions were followed-up by imaging and clinical examination. Separately for nodal-positive and nodal-negative women, a McNemar chi 2 test was performed to compare sensitivity and specificity of the N and M stages between 18 F-FDG PET/MRI and MRI. Differences in diagnostic confidence scores were assessed by Wilcoxon signed rank test. Results MRI determined the N stage correctly in 78 of 104 (75%) patients with a sensitivity of 62.3% (95% CI: 0.48–0.75), a specificity of 88.2% (95% CI: 0.76–0.96), a PPV (positive predictive value) of 84.6% % (95% CI: 69.5–0.94), and a NPV (negative predictive value) of 69.2% (95% CI: 0.57–0.8). Corresponding results for 18 F-FDG PET/MRI were 87/104 (83.7%), 75.5% (95% CI: 0.62–0.86), 92.2% (0.81–0.98), 90% (0.78–0.97), and 78.3% (0.66–0.88), showing a significantly better sensitivity of 18 F-FDG PET/MRI determining malignant lymph nodes ( p  = 0.008). The M stage was identified correctly in MRI and 18 F-FDG PET/MRI in 100 of 104 patients (96.2%). Both modalities correctly staged all 7 patients with distant metastases, leading to false-positive findings in 4 patients in each modality (3.8%). In a lesion-based analysis, 18 F-FDG PET/MRI showed a significantly better performance in correctly determining malignant lesions (85.8% vs. 67.1%, difference 18.7% (95% CI: 0.13–0.26), p   〈  0.0001) and offered a superior diagnostic confidence compared with MRI alone (4.1 ± 0.7 vs. 3.4 ± 0.7, p   〈  0.0001). Conclusion 18 F-FDG PET/MRI has a better diagnostic accuracy for N staging in primary breast cancer patients and provides a significantly higher diagnostic confidence in lesion characterization than MRI alone. But both modalities bear the risk to overestimate the M stage.
    Type of Medium: Online Resource
    ISSN: 1619-7070 , 1619-7089
    URL: Article
    DOI: 10.1007/s00259-020-04801-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2098375-X
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 2
    Online Resource
    Online Resource
    Prospective Correlation of Prognostic Immunohistochemical Markers With SUV and ADC Derived From Dedicated Hybrid Breast 18F-FDG PET/MRI in Women With Newly Diagnosed Breast Cancer
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Clinical Nuclear Medicine Vol. 46, No. 3 ( 2021-3), p. 201-205
    Details
    In: Clinical Nuclear Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 3 ( 2021-3), p. 201-205
    Abstract: The aim of this study was to correlate prognostically relevant immunohistochemical parameters of breast cancer with simultaneously acquired SUVs and apparent diffusion coefficient (ADC) values derived from hybrid breast PET/MRI. Patients and Methods Fifty-six women with newly diagnosed, therapy-naive, histologically proven breast cancer (mean age, 54.1 ± 12.0 years) underwent dedicated prone 18 F-FDG breast PET/MRI. Diffusion-weighted imaging ( b -values: 0, 500, 1000 s/mm 2 ) was performed simultaneously with the PET acquisition. A region of interest encompassing the entire primary tumor on each patient’s PET/MRI scan was used to determine the glucose metabolism represented by maximum and mean SUV as well as into corresponding ADC maps to assess tumor cellularity represented by mean and minimum ADC values. Histopathological tumor grading and prognostically relevant immunohistochemical markers, that is, Ki67, progesterone receptor, estrogen receptor, and human epidermal growth factor receptor 2 (HER2), were assessed. Pearson correlation coefficients were calculated to compare SUV and ADC values as well as the immunohistochemically markers and molecular subtype. For the comparison with the tumor grading, a Wilcoxon test was used. Results A significant inverse correlation between SUV and ADC values derived from breast PET/MRI ( r = −0.49 for SUV mean vs ADC mean ; r = −0.43 for SUV max vs ADC min ; both P ’s 〈 0.001) was found. Tumor grading and Ki67 both showed a positive correlation with SUV mean from breast PET/MRI ( r = 0.37 and r = 0.32, P 〈 0.01). For immunohistochemical markers, HER2 showed an inverse correlation with ADC values from breast PET/MRI ( r = −0.35, P 〈 0.01). Molecular subtypes significantly correlate with SUV max and SUV mean ( r = 0.52 and r = 0.42, both P ’s 〈 0.05). In addition, estrogen receptor expression showed an inverse correlation with SUV max and SUV mean from breast PET/MRI ( r = −0.45 and r = −0.42, P 〈 0.001). Conclusions The present data show a correlation between increased glucose metabolism, cellularity, tumor grading, estrogen and HER2 expression, as well as molecular subtype of breast cancer primaries. Hence, simultaneous 18 F-FDG PET and diffusion-weighted imaging from hybrid breast PET/MRI may serve as a predictive tool for identifying high-risk breast cancer patients in initial staging and guide-targeted therapy.
    Type of Medium: Online Resource
    ISSN: 1536-0229 , 0363-9762
    URL: Article
    DOI: 10.1097/RLU.0000000000003488
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2045053-9
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 3
    Online Resource
    Online Resource
    Is there a connection between immunohistochemical markers and grading of lung cancer with apparent diffusion coefficient (ADC) and standardised uptake values (SUV) of hybrid 18F‐FDG‐PET/MRI?
    Wiley ; 2020
    In:  Journal of Medical Imaging and Radiation Oncology Vol. 64, No. 6 ( 2020-12), p. 779-786
    Details
    In: Journal of Medical Imaging and Radiation Oncology, Wiley, Vol. 64, No. 6 ( 2020-12), p. 779-786
    Abstract: To correlate tumour grading and prognostic immunohistochemical markers of lung cancer with simultaneously acquired standardised uptake values (SUV) and apparent diffusion coefficient (ADC) derived from hybrid PET/MRI. Methods In this retrospective study, 55 consecutive patients (mean age 62.5 ± 9.2 years) with therapy‐naïve, histologically proven lung cancer were included. All patients underwent whole‐body PET/MRI using 18F‐flourdeoxyglucose (18F‐FDG) as a radiotracer. Diffusion‐weighted imaging of the chest (DWI, b‐values: 0, 500, 1000 s/mm 2 ) was performed simultaneously with PET acquisition. Histopathological tumour grading was available in 43/55 patients. In 15/55 patients, immunohistochemical markers, that is, phospho‐AKT Ser473 (pAKTS473), phosphorylated extracellular signal‐regulated kinase (pERK), phosphatase and tensin homolog (PTEN), and human epidermal growth factor receptor 2 (erbB2) were available. Results The average SUVmax, SUVmean, ADCmin and ADCmean in lung cancer primaries were 12.6 ± 5.9, 7.7 ± 4.6, 569.9 ± 96.1 s/mm 2 and 825.8 ± 93.2 s/mm 2 , respectively. We found a significant inverse correlation between the ADCmin and SUVmax ( r  = −0.58, P   〈  0.001) as well as between the ADCmin and SUVmean ( r  = −0.44, P   〈  0.001). Tumour grading showed a significant positive correlation with SUVmax and SUVmean ( R  = 0.34 and R  = 0.31, both P   〈  0.05) and a significant inverse correlation with ADCmin and ADCmean ( r  = −0.30 and r  = −0.40, both P   〈  0.05). In addition, erbB2 showed a significant inverse correlation with SUVmax and SUVmean ( r  = −0.50 and r  = −0.49, both P   〈  0.05). The other immunohistochemical markers did not show any significant correlation. Conclusion 18F‐FDG‐PET/MRI showed weak to moderate correlations between SUV, ADC, tumour grading and erbB2‐expression of lung cancer. Hence, 18F‐FDG‐PET/MRI may, to some extent, offer complementary information to the histopathology of lung cancer, for the evaluation of tumour aggressiveness and treatment response.
    Type of Medium: Online Resource
    ISSN: 1754-9477 , 1754-9485
    URL: Issue
    URL: Article
    DOI: 10.1111/jmiro.v64.6
    DOI: 10.1111/1754-9485.13087
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2409071-2
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 4
    Online Resource
    Online Resource
    Targeting Different Monocyte/Macrophage Subsets Has No Impact on Outcome in Experimental Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Stroke Vol. 48, No. 4 ( 2017-04), p. 1061-1069
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. 4 ( 2017-04), p. 1061-1069
    Abstract: Peripheral immune cell infiltration contributes to neural injury after ischemic stroke. However, in contrast to lymphocytes and neutrophils, the role of different monocyte/macrophage subsets remains to be clarified. Therefore, we evaluated the effects of selective and unselective monocyte/macrophage depletion and proinflammatory (M1-) and anti-inflammatory (M2-) macrophage transfer on the outcome after experimental cerebral ischemia. Methods— To assess short-term effects of monocytes/macrophages in acute ischemic stroke, mice underwent transient middle cerebral artery occlusion and received either clodronate liposomes for unselective macrophage depletion, MC-21-antibody for selective depletion of proinflammatory Ly-6C high monocytes, or proinflammatory (M1-) or anti-inflammatory (M2-) macrophage transfer. In addition, the impact of MC-21-antibody administration and M2-macrophage transfer on long-term neural recovery was investigated after photothrombotic stroke. Neurobehavioral tests were used to analyze functional outcomes, infarct volumes were determined, and immunohistochemical analyses were performed to characterize the postischemic inflammatory reaction. Results— Selective and unselective monocyte/macrophage depletion and M1- and M2-macrophage transfer did not influence tissue damage and neurobehavioral outcomes in the acute phase after middle cerebral artery occlusion. Beyond, selective depletion of Ly-6C high monocytes and M2-macrophage transfer did not have an impact on neural recovery after photothrombotic stroke. Conclusions— Targeting different monocyte/macrophage subsets has no impact on outcome after ischemic stroke in mice. Altogether, our study could not identify monocytes/macrophages as relevant therapeutic targets in acute ischemic stroke.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.116.015577
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1467823-8
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 5
    Online Resource
    Online Resource
    [18F]FDG PET/MRI in children suffering from lymphoma: does MRI contrast media make a difference?
    Springer Science and Business Media LLC ; 2023
    In:  European Radiology
    Details
    In: European Radiology, Springer Science and Business Media LLC
    Abstract: Evaluate the influence of an MRI contrast agent application on primary and follow-up staging in pediatric patients with newly diagnosed lymphoma using [ 18 F]FDG PET/MRI to avoid adverse effects and save time and costs during examination. Methods A total of 105 [ 18 F]FDG PET/MRI datasets were included for data evaluation. Two different reading protocols were analyzed by two experienced readers in consensus, including for PET/MRI-1 reading protocol unenhanced T2w and/or T1w imaging, diffusion-weighted imaging (DWI), and [ 18 F]FDG PET imaging and for PET/MRI-2 reading protocol an additional T1w post contrast imaging. Patient-based and region-based evaluation according to the revised International Pediatric Non-Hodgkin’s Lymphoma (NHL) Staging System (IPNHLSS) was performed, and a modified standard of reference was applied comprising histopathology and previous and follow-up cross-sectional imaging. Differences in staging accuracy were assessed using the Wilcoxon and McNemar tests. Results In patient-based analysis, PET/MRI-1 and PET/MRI-2 both determined a correct IPNHLSS tumor stage in 90/105 (86%) exams. Region-based analysis correctly identified 119/127 (94%) lymphoma-affected regions. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for PET/MRI-1 and PET/MRI-2 were 94%, 97%, 90%, 99%, 97%, respectively. There were no significant differences between PET/MRI-1 and PET/MRI-2. Conclusions The use of MRI contrast agents in [ 18 F]FDG PET/MRI examinations has no beneficial effect in primary and follow-up staging of pediatric lymphoma patients. Therefore, switching to a contrast agent–free [ 18 F]FDG PET/MRI protocol should be considered in all pediatric lymphoma patients. Clinical relevance statement This study gives a scientific baseline switching to a contrast agent–free [ 18 F]FDG PET/MRI staging in pediatric lymphoma patients. This could avoid side effects of contrast agents and saves time and costs by a faster staging protocol for pediatric patients. Key Points • No additional diagnostic benefit of MRI contrast agents at [ 18 F]FDG PET/MRI examinations of pediatric lymphoma primary and follow-up staging • Highly accurate primary and follow-up staging of pediatric lymphoma patients at MRI contrast–free [ 18 F]FDG PET/MRI
    Type of Medium: Online Resource
    ISSN: 1432-1084
    URL: Article
    DOI: 10.1007/s00330-023-09840-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1472718-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 6
    Online Resource
    Online Resource
    Reply
    Wiley ; 2023
    In:  Arthritis & Rheumatology Vol. 75, No. 5 ( 2023-05), p. 864-865
    Details
    In: Arthritis & Rheumatology, Wiley, Vol. 75, No. 5 ( 2023-05), p. 864-865
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Issue
    URL: Article
    DOI: 10.1002/art.v75.5
    DOI: 10.1002/art.42399
    RVK:
    XA 10000
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2754614-7
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 7
    Online Resource
    Online Resource
    Free-breathing 3D Stack of Stars GRE (StarVIBE) sequence for detecting pulmonary nodules in 18F-FDG PET/MRI
    Springer Science and Business Media LLC ; 2022
    In:  EJNMMI Physics Vol. 9, No. 1 ( 2022-12)
    Details
    In: EJNMMI Physics, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2022-12)
    Abstract: The free-breathing T1-weighted 3D Stack of Stars GRE (StarVIBE) MR sequence potentially reduces artifacts in chest MRI. The purpose of this study was to evaluate StarVIBE for the detection of pulmonary nodules in 18 F-FDG PET/MRI. Material and methods In this retrospective analysis, conducted on a prospective clinical trial cohort, 88 consecutive women with newly diagnosed breast cancer underwent both contrast-enhanced whole-body 18 F-FDG PET/MRI and computed tomography (CT). Patients’ chests were examined on CT as well as on StarVIBE and conventional T1-weighted VIBE and T2-weighted HASTE MR sequences, with CT serving as the reference standard. Presence, size, and location of all detectable lung nodules were assessed. Wilcoxon test was applied to compare nodule features and Pearson’s, and Spearman’s correlation coefficients were calculated. Results Out of 65 lung nodules detected in 36 patients with CT (3.7 ± 1.4 mm), StarVIBE was able to detect 31 (47.7%), VIBE 26 (40%) and HASTE 11 (16.8%), respectively. Overall, CT showed a significantly higher detectability than all MRI sequences combined (65 vs. 36, difference 44.6%, p   〈  0.001). The VIBE showed a significantly better detection rate than the HASTE (23.1%, p  = 0.001). Detection rates between StarVIBE and VIBE did not significantly differ (7.7%, p  = 0.27), but the StarVIBE showed a significant advantage detecting centrally located pulmonary nodules (66.7% vs. 16.7%, p  = 0.031). There was a strong correlation in nodule size between CT and MRI sequences (HASTE: ρ  = 0.80, p  = 0.003; VIBE: ρ  = 0.77, p   〈  0.001; StarVIBE: ρ  = 0.78, p   〈  0.001). Mean image quality was rated as good to excellent for CT and MRI sequences. Conclusion The overall lung nodule detection rate of StarVIBE was slightly, but not significantly, higher than conventional T1w VIBE and significantly higher than T2w HASTE. Detectability of centrally located nodules is better with StarVIBE than with VIBE. Nevertheless, all MRI analyses demonstrated considerably lower detection rates for small lung nodules, when compared to CT.
    Type of Medium: Online Resource
    ISSN: 2197-7364
    URL: Article
    DOI: 10.1186/s40658-022-00439-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2768912-8
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 8
    Online Resource
    Online Resource
    Comparison of nodal staging between CT, MRI, and [18F]-FDG PET/MRI in patients with newly diagnosed breast cancer
    Springer Science and Business Media LLC ; 2022
    In:  European Journal of Nuclear Medicine and Molecular Imaging Vol. 49, No. 3 ( 2022-02), p. 992-1001
    Details
    In: European Journal of Nuclear Medicine and Molecular Imaging, Springer Science and Business Media LLC, Vol. 49, No. 3 ( 2022-02), p. 992-1001
    Abstract: To compare CT, MRI, and [ 18 F]-fluorodeoxyglucose positron emission tomography ([ 18 F]-FDG PET/MRI) for nodal status, regarding quantity and location of metastatic locoregional lymph nodes in patients with newly diagnosed breast cancer. Materials and methods One hundred eighty-two patients (mean age 52.7 ± 11.9 years) were included in this prospective double-center study. Patients underwent dedicated contrast-enhanced chest/abdomen/pelvis computed tomography (CT) and whole-body ([ 18 F]-FDG PET/) magnet resonance imaging (MRI). Thoracal datasets were evaluated separately regarding quantity, lymph node station (axillary levels I–III, supraclavicular, internal mammary chain), and lesion character (benign vs. malign). Histopathology served as reference standard for patient-based analysis. Patient-based and lesion-based analyses were compared by a McNemar test. Sensitivity, specificity, positive and negative predictive values, and accuracy were assessed for all three imaging modalities. Results On a patient-based analysis, PET/MRI correctly detected significantly more nodal positive patients than MRI ( p   〈  0.0001) and CT ( p   〈  0.0001). No statistically significant difference was seen between CT and MRI. PET/MRI detected 193 lesions in 75 patients (41.2%), while MRI detected 123 lesions in 56 patients (30.8%) and CT detected 104 lesions in 50 patients, respectively. Differences were statistically significant on a lesion-based analysis (PET/MRI vs. MRI, p   〈  0.0001; PET/MRI vs. CT, p   〈  0.0001; MRI vs. CT, p  = 0.015). Subgroup analysis for different lymph node stations showed that PET/MRI detected significantly more lymph node metastases than MRI and CT in each location (axillary levels I–III, supraclavicular, mammary internal chain). MRI was superior to CT only in axillary level I ( p  = 0.0291). Conclusion [ 18 F]-FDG PET/MRI outperforms CT or MRI in detecting nodal involvement on a patient-based analysis and on a lesion-based analysis. Furthermore, PET/MRI was superior to CT or MRI in detecting lymph node metastases in all lymph node stations. Of all the tested imaging modalities, PET/MRI showed the highest sensitivity, whereas CT showed the lowest sensitivity, but was most specific.
    Type of Medium: Online Resource
    ISSN: 1619-7070 , 1619-7089
    URL: Article
    DOI: 10.1007/s00259-021-05502-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2098375-X
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 9
    Online Resource
    Online Resource
    Update on Locoregional Therapies for Cholangiocellular Carcinoma
    MDPI AG ; 2023
    In:  Cancers Vol. 15, No. 8 ( 2023-04-19), p. 2368-
    Details
    In: Cancers, MDPI AG, Vol. 15, No. 8 ( 2023-04-19), p. 2368-
    Abstract: Locoregional therapy options for CCA are used, in particular, for non-resectable tumors and aim to reduce tumor viability or delay tumor growth and ultimately prolong overall survival. In addition to local ablative procedures such as radiofrequency- or microwave-ablation, transarterial procedures such as transarterial embolization (TAE), transarterial chemoembolization (TACE), or selective internal radiotherapy (SIRT) play a major role. In particular, in combination with advances in molecular medicine and immunotherapy, there has been a further development in the therapy of primary malignant liver tumors in recent years. In this review, we analyze data from recent studies and examine the implications for therapy of CCA, particularly with regard to the combination of locoregional therapies with modern systemic therapies.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers15082368
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2527080-1
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 10
    Online Resource
    Online Resource
    Why Most Acute Stroke Studies Are Positive in Animals but Not in Patients: A Systematic Comparison of Preclinical, Early Phase, and Phase 3 Clinical Trials of Neuroprotective Agents
    Wiley ; 2020
    In:  Annals of Neurology Vol. 87, No. 1 ( 2020-01), p. 40-51
    Details
    In: Annals of Neurology, Wiley, Vol. 87, No. 1 ( 2020-01), p. 40-51
    Abstract: To analyze why numerous acute stroke treatments were successful in the laboratory but failed in large clinical trials. Methods We searched all phase 3 trials of medical treatments for acute ischemic stroke and corresponding early clinical and experimental studies. We compared the overall efficacy and assessed the impact of publication bias and study design on the efficacy. Furthermore, we estimated power and true report probability of experimental studies. Results We identified 50 phase 3 trials with 46,008 subjects, 75 early clinical trials with 12,391 subjects, and 209 experimental studies with 〉 7,141 subjects. Three (6%) phase 3, 24 (32%) early clinical, and 143 (69.08%) experimental studies were positive. The mean treatment effect was 0.76 (95% confidence interval [CI] = 0.70–0.83) in experimental studies, 0.87 (95% CI = 0.71–1.06) in early clinical trials, and 1.00 (95% CI = 0.95–1.06) in phase 3 trials. Funnel plot asymmetry and trim‐and‐fill revealed a clear publication bias in experimental studies and early clinical trials. Study design and adherence to quality criteria had a considerable impact on estimated effect sizes. The mean power of experimental studies was 17%. Assuming a bias of 30% and pre‐study odds of 0.5 to 0.7, this leads to a true report probability of 〈 50%. Interpretation Pivotal study design differences between experimental studies and clinical trials, including different primary end points and time to treatment, publication bias, neglected quality criteria and low power, contribute to the stepwise efficacy decline of stroke treatments from experimental studies to phase 3 clinical trials. Even under conservative estimates, less than half of published positive experimental stroke studies are truly positive. ANN NEUROL 2020;87:40–51
    Type of Medium: Online Resource
    ISSN: 0364-5134 , 1531-8249
    URL: Issue
    URL: Article
    DOI: 10.1002/ana.v87.1
    DOI: 10.1002/ana.25643
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2037912-2
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
Nothing or not found what you are looking for? Please check your search query or use the Interlibrary Loan Search.
Close ⊗
This website uses cookies and the analysis tool Matomo. Further information can be found on the KOBV privacy pages