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. Stanisz^1,5,6

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

Synopsis

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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