Predictive Value of Multimodal MRI using spectroscopy and perfusion can distinguish between pseudoprogression and disease progression in GBM
Mohamed Ehab El-Abtah1, Pratik Talati 2, Melanie Fu1, Benjamin Chun1, Patrick Clark1, Anna Peters 1, Anthony Ranasinghe1, Julian He 1, Otto Rapalino1,3, Gilberto Gonzalez 1,3, William Curry 2, Jorg Dietrich 3,4, Elizabeth Gerstner4, and Eva-Maria Ratai 1,3
1Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, United States, 2Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States, 3Harvard Medical School, Boston, MA, United States, 4Cancer Center, Massachusetts General Hospital, Boston, MA, United States
There is a need to determine clinical markers that can distinguish between pseudoprogression (PsP) and true progression after patients with GBM undergo resection followed by chemoradiation. We conducted a retrospective study of collected magnetic resonance spectroscopic imaging (MRSI) and perfusion weighted imaging (PWI) data with the aim of investigating their utility in predicting tumor progression. Within the enhancing region on post-contrast T1 imaging, patients with true progression have decreased myo-Inositol normalized by contralateral creatinine (mI/c-Cr), elevated lactate normalized to glutamate+glutamine (Lac/Glx), and elevated relative cerebral blood flow (rCBF) relative to those with PsP.
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