Yan Li1, Janine M. Lupo1, Soonmee Cha1, Susan Chang2, Sarah J. Nelson1,3
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States; 2Department of Neurological Surgery, University of California, San Francisco, CA, United States; 3Department of Bioengineering & Therapeutic Sciences, University of California, San Francisco, CA, United States
Glioblastoma Multiforme (GBM) is the most common and malignant type of primary brain tumor, resulting in a median survival of approximately one year. Our study of 18 patients with GBM indicated that metabolic abnormalities more accurately reflect the underlying tumor burden. We found that the Cho to NAA index (CNI) values in the contrast-enhancing lesion (CEL) are elevated at 2 months prior to progression while having less changes in CEL volume at that time. Patients who have a CEL volume with high CNI values are more likely to progress compared with those who have with smaller CEL volume and lower CNI values. We also observed that the regions with high CNI values outside the CEL region could subsequently become enhancing.