Glioblastoma (GBM) is a grade IV primary brain tumor with poor outcomes despite surgical resection, chemotherapy, and radiation. Often, disease will recur in regions in the penumbra of the treatment volume, hypothesized to occur because anatomic MRI does not fully capture neoplastic infiltration. Spectroscopic magnetic resonance imaging (sMRI) enables in vivo whole-brain analysis of metabolic activity, and has been shown to sensitively and specifically identify regions of non-enhancing, infiltrating tumor. We present an ongoing prospective clinical study to target metabolically active tumor identified by sMRI for a radiation boost, with the aim of improving outcome in patients with GBM.
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