Metabolic imaging of brain tumor responses to radio-chemotherapy can give an early indication of treatment outcome. We show here that Deuterium Metabolic Imaging (DMI) with 2H-labeled fumarate is more sensitive than diffusion weighted 1H imaging (DWI) in detecting early evidence of cell death following radio-chemotherapy in orthotopically implanted patient-derived glioblastoma xenografts. 2H spectra were acquired from tumors with a time resolution of 5min, following an injection of 2H-labelled fumarate. Within 48h after the last chemo-radiotherapy treatment (CRT) the rate of tumor malate production from labelled fumarate increased significantly, whereas changes in ADC values were only detectable 7 days post treatment.
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