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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. Stanisz1,3,4
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


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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