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Abstract #4179

Whole-brain echo planar spectroscopic imaging distinguishes recurrent tumor versus pseudoprogression in glioblastoma patients

Gaurav Verma1, Suyash Mohan1, Sanjeev Chawla1, Sumei Wang1, Andrew Maudsley2, Ronald Wolf1, Steven Brem3, Robert Lustig4, Arati Desai5, and Harish Poptani6

1Department of Neuroradiology, University of Pennsylvania, Philadelphia, PA, United States, 2Department of Radiology, University of Miami, Miami, FL, United States, 3Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States, 4Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, United States, 5Department of Hematology/Oncology, University of Pennsylvania, Philadelphia, PA, United States, 6Department of Cellular and Molecular Physiology, University of Liverpool, Liverpool, United Kingdom

Differentiating brain tumor recurrence (True Progression, TP) from treatment effect (pseudoprogression, PsP) among enhancing neoplasms following radiation therapy by non-inavsive imaging may directly inform treatment strategies, yet similar imaging patterns makes this difficult leading to invasive biopsy or repeat surgery. Three-dimensional echo-planar spectroscopic imaging (EPSI) facilitates region-of-interest analysis with high-resolution metabolic data. In this study, we compared seven patients with PsP and seven with recurrent tumor using EPSI. Higher choline was detected from the contrast-enhancing, peritumoral and distal peritumoral regions in TP patients compared to PsP.

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