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Abstract #2252

Metabolic activity of the invasive microenvironment of glioblastomas determines time to progression: a multimodal MR study

Stephen J. Price 1,2 , Adam MH Young 1 , William J Scotton 1 , Natalie R Boonzaier 1 , Victoria C Lupson 2 , Mary A McLean 3 , and Timothy J Larkin 1,2

1 Academic Neurosurgery Division, Dept. Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom, 2 Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, United Kingdom, 3 Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom

Most patients with glioblastomas will die from disease progressing adjacent to the resected tumor. This invasive margin is a cardinal feature of glioblastomas and cannot be seen on conventional imaging but can be identified with diffusion tensor imaging. By outlining the DTI-defined region of tumour invasion we can use perfusion and MR spectroscopy to explore the microenvironment. This study shows that patients with more metabolically active invasive margins (defined as Cho/NAA > 0.6) have a significantly longer progression free survival. This suggests that cytotoxic therapies have increased efficacy with more proliferative and metabolically active invasive margins.

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