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Abstract #2899

Restriction Spectrum Imaging differentiates True Progression from Pseudoprogression in patients with high grade glioma following treatment with immunotherapy

Naeim Bahrami1, Shadi Daghighi1, William Tom1, Nikdokht Farid1, and Carrie McDonald1

1University of California, San Diego, San Diego, CA, United States

Immunotherapy is becoming more frequently used in patients with high grade glioma (HGG) following standard chemoradiation. However, immune-mediated pseudoprogression (PsP) is a growing problem that remains poorly characterized and renders conventional imaging less useful. We evaluate the ability of a novel, advanced diffusion model, restriction spectrum imaging (RSI) to differentiate PsP from TP following immunotherapy. We demonstrate that an RSI-derived measure of axonal integrity (neurite density; ND) can differentiate TP from PsP, correctly classifying 73% of patients. We conclude that lower RSI-ND reflects disruption of axonal microstructure and may provide an imaging marker of tumor infiltration in patients with TP.

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