Abstract #3409

Tracking acute & chronic RT-induced fibrosis in cervical cancer using native & Late-Gadolinium-Enhancement Short-Inversion-Time (STIR) UTE

Khadija Sheikh¹, Junghoon Lee², Marc Morcos², Mohammad Rezae², Ravi T. Seethamraju³, Thomas Benkert⁴, Himanshu Bhat³, Henry R Halperin⁵, Bruce L. Daniel⁶, Akila N Viswanathan², and Ehud J Schmidt^2,5

¹Johns Hopkins School of Medicine, Washington, DC, United States, ²Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States, ³Siemens Medical Solutions, Boston, MA, United States, ⁴MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany, ⁵Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, United States, ⁶Radiology, Stanford University, Stanford, CA, United States

Synopsis

Imaging the temporal evolution of post-radiation fibrosis, which forms in irradiated tissues, supports quantifying tumor response and estimating surrounding-tissue injury. Five cervical cancer patients were scanned pre-external-beam-radiotherapy (EBRT), during and after EBRT, and 3-months post-EBRT and High-Dose-Rate (HDR) brachytherapy. A novel stack-of-spirals STIR-UTE sequence (TI=60ms) was used to image acute-fibrosis, utilizing collagen-bound-water’s short T2* and T1, and Late-Gadolinium-Enhancement (11-15min post-contrast) IR-UTE sequence (TI=200ms) to image chronic-fibrosis, utilizing scar’s slow-contrast-perfusion. Acute-fibrosis spatial-distribution followed EBRT and brachytherapy dose distributions. Over time, acute-fibrosis was converted into chronic-fibrosis. This is important as it forms the basis to guide radiation-therapy for re-irradiation and adaptive-planning.

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