Benjamin M. Ellingson1,2, Mark G. Malkin1,3,
Scott D. Rand1,2, Jennifer M. Connelly1,4, Pete S.
LaViolette1,5, Devyani P. Bedakar1,2, Kathleen M.
Schmainda1,2
1Translational Brain Tumor Program, Medical
College of Wisconsin, Milwaukee, WI, United States; 2Dept. of
Radiology, Medical College of Wisconsin, Milwaukee, WI, United States; 3Dept.
of Neurology and Neurosurgery, Medical College of Wisconsin, Milwaukee, WI,
United States; 4Dept. of Neurology, Medical College of Wisconsin,
Milwaukee, WI, United States; 5Dept. of Biophysics, Medical
College of Wisconsin, Milwaukee, WI, United States
Patients
with malignant gliomas undergoing cytotoxic therapy have been shown to have an
increase in the size of contrast-enhancing lesions due to radiation necrosis;
however, growing or progressing gliomas also are trademarked by an increase
in the size of contrast-enhancing lesions. This phenomenon, known as
pseudoprogression, is of significant clinical interest because routine
anatomical MRI techniques cannot relibly distinguish these two mechanisms of
contrast enhancement during therapy. In the current study, we examine the
kinetic profiles of hyper- and hypocellular volumes using functional
diffusion maps (fDMs) applied in FLAIR abnormal regions in order to detect
pseudoprogression from recurrent tumor in malignant glioma patients treated
with cytotoxic therapies.
Keywords