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Abstract #4458

Differentiating Radiation Necrosis from Tumour Progression in Brain Metastases using CEST: A Cross-Vendor Comparison

Rachel W. Chan1, Wilfred W. Lam1, Patrick Liebig2, Leedan Murray1, Hatef Mehrabian1, Aimee Theriault3, Ruby Endre1, Garry Detzler1, Sten Myrehaug3, Chia-Lin Tseng3, Jay Detsky3, Pejman J. Maralani4, Arjun Sahgal3, Hany Soliman3, and Greg J. Stanisz1,5,6
1Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada, 2Siemens Healthineers, Erlangen, Germany, 3Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 4Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada, 5Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada, 6Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Lublin, Poland


Stereotactic radiosurgery for the treatment of brain metastases delivers a high dose of radiation with excellent local control, but increases the likelihood of radiation necrosis. CEST is a promising technique for distinguishing radiation necrosis from tumour progression in brain metastases, but its application has been limited to a single MRI system and CEST sequence. This study explores the use of scaling of the magnetization transfer ratio (MTR) by the white matter (WM) of each patient for comparison across vendors/sequences. It was found that the WM-scaled MTR showed improved correspondence across the MR systems, across two CEST sequences.

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