Abstract #4244

Differentiation of Radiation Necrosis from Tumour Progression Using Chemical Exchange Saturation Transfer (CEST)

Hatef Mehrabian^1,2, Hany Soliman³, Arjun Sahgal³, and Greg J Stanisz²

¹Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, ²Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada, ³Radiation Oncology, Sunnybrook Research Institute, Toronto, ON, Canada

Radiation necrosis is the most common side-effect of stereotactic radiosurgery (SRS) and has similar characteristics to tumor progression on standard anatomical MRI. Differentiating these two conditions is a major long standing clinical challenge. In this study the potential of chemical exchange saturation transfer (CEST) in differentiating the two conditions in patient with brain metastases is investigated. The results showed that the magnetization transfer ratio (MTR) of amide and NOE peaks provided the best separation of radiation necrosis cases from tumor progression cases. However, the commonly used amide proton transfer (APT) was unable to differentiate the two conditions.

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