Abstract #4457

Saturation Transfer MRI in a Clinical Setting for Differentiating Radiation Necrosis from Tumour Progression in Brain Metastases

Rachel W. Chan¹, Hatef Mehrabian¹, Arjun Sahgal², Hanbo Chen², Aimee Theriault², Wilfred W. Lam¹, Sten Myrehaug², Chia-Lin Tseng², Zain Husain², Jay Detsky², Hany Soliman², and Greg J. Stanisz^1,3,4

¹Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada, ²Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, ³Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada, ⁴Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Lublin, Poland

Synopsis

Stereotactic radiosurgery for brain metastases delivers a focal dose of radiation and has excellent local tumour control but leads to radiation necrosis (RN) in up to 22% of patients. This study used saturation transfer MRI for distinguishing between RN and tumour progression (TP), extending our previous work to a larger cohort of 70 patients (75 lesions). Eleven out of 14 metrics (including quantitative MT and CEST) showed statistically significant differences between the RN and TP cohorts, including magnetization transfer ratio (MTR) metrics showing the best separation. Univariable logistic regression resulted in the high-power MTR having the highest AUC=0.88 (with AIC=67.3).

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