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Abstract #3709

Differentiation of Radiation Necrosis from Tumor Progression in Brain Metastasis Treated with Stereotactic Radiosurgery using CEST at 3T

Rachel W Chan1, Hatef Mehrabian1, Hany Soliman2, Hanbo Chen2, Aimee Theriault2, Sten Myrehaug2, Chia-Lin Tseng2, Jay Detsky2, Wilfred W Lam1, Angus Z Lau1,3, Gregory J Czarnota1,2,3, Arjun Sahgal2, and Greg J Stanisz1,3,4
1Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada, 2Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 3Medical Biophysics, Sunnybrook Research Institute, Toronto, ON, Canada, 4Department of Neurosurgery and Pediatric Neurosurgery, Medical University, Lublin, Poland

Stereotactic radiosurgery (SRS) is the standard of care treatment for patients with limited brain metastases; however radiation necrosis can develop. Standard clinical approaches have limited ability in differentiating radiation-induced changes from tumor progression. This work examines the performance of CEST metrics (MTRAmide and MTRrNOE) at 3T for differentiating radiation necrosis from tumor progression, extending a previous study to include higher saturation power (using B1=2.0μT) with added multivariable logistic regression. Results in 24 lesions showed that both saturation powers (0.52μT and 2.0μT) could distinguish tumor progression from radiation necrosis, with the MTRAmide(0.52μT) parameter selected from multivariable modelling with AUC=0.91.

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