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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