Glioblastoma multiforme (GBM) is an infiltrating and heterogeneous disease with low median survival and over 70% recurrence rates, though 20-30% of progressive enhancing lesions seen in GBM post-treatment exhibit pseudoprogression rather than true recurrent tumor. Differentiating these could improve speed and accuracy of treatment. A statistical and histogram analysis of segmented high-resolution echo-planar spectroscopic imaging data goes beyond mean metabolite ratios to show distribution of Cho/NAA and Cho/Cr ratios in contrast enhancing regions and the surrounding tissue. Cho/NAA distribution in enhancing region showed greater kurtosis than Cho/Cr, suggesting reduction in NAA may be a driving factor in observed Cho/NAA increases.
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