(ISMRM 2024) First demonstration of arterial spin labeling on a 1.5T MR-Linac for characterizing glioblastoma perfusion dynamics
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Abstract #0444

First demonstration of arterial spin labeling on a 1.5T MR-Linac for characterizing glioblastoma perfusion dynamics

Liam S. P. Lawrence1, Brige Chugh2,3, James Stewart2, Mark Ruschin2, Aimee Theriault2, Jay Detksy2, Sten Myrehaug2, Pejman J. Maralani2, Chia-Lin Tseng2, Hany Soliman2, Mary Jane Lim-Fat4, Sunit Das5, Arjun Sahgal2, and Angus Z. Lau1,6
1Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada, 2Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 3Department of Physics, Toronto Metropolitan University, Toronto, ON, Canada, 4Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 5Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada, 6Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada

Synopsis

Keywords: MR-Guided Radiotherapy, Tumor, MR-Linac, perfusion, glioblastoma

Motivation: Glioblastoma is a highly vascularized brain tumor. Changes in perfusion could guide treatment adaptation, but the dynamics of blood flow changes in glioblastoma during radiotherapy are poorly understood.

Goal(s): We sought to characterize changes in glioblastoma cerebral blood flow during radiotherapy.

Approach: We acquired twice-weekly arterial spin labeling (ASL) MRI in 22 glioblastoma patients during radiotherapy on a 1.5T MRI-linear accelerator (MR-Linac) and evaluated changes in cerebral blood flow.

Results: We provided the first demonstration of MR-Linac ASL. Tumor cerebral blood flow tended to decrease during radiotherapy. Highly-perfused tumor regions showed the greatest change.

Impact: We showed that frequent perfusion imaging on MRI-linear accelerators is feasible and that blood flow in highly-perfused regions of human glioblastoma tends to decrease during radiotherapy. Radiotherapy with dose escalation to highly perfused tumor regions likely requires target adaptation.

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Keywords

perfusiontumorpatientsarterial