Abstract #2298

CEST contrasts remain stable in normal-appearing brain tissues but reveal tumor-specific alterations after radiotherapy in glioma patients

Sebastian Regnery^1,2, Nikolaus von Knebel Döberitz³, Florian Kroh^2,4, Philip Boyd⁴, Petr Menshchikov⁴, Svenja Graß³, Cora Bauspieß³, Mark E Ladd^4,5, Jürgen Debus¹, Heinz-Peter Schlemmer^3,5, Andreas Korzowski⁴, Laila König¹, and Daniel Paech^2,3

¹Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany, ²Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States, ³Division of Radiology, German Cancer Research Center, Heidelberg, Germany, ⁴Division of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany, ⁵Faculty of Physics and Astronomy and Faculty of Medicine, Heidelberg University, Heidelberg, Germany

Synopsis

Keywords: CEST / APT / NOE, Radiotherapy

Motivation: Routine MRI struggles to differentiate tumor progression from treatment-induced changes in glioma patients after chemoradiotherapy (CRT). Chemical exchange saturation transfer (CEST) yields metabolic information and could support a reliable differentiation.

Goal(s): To explore potentially different CEST contrast changes in normal-appearing brain tissue and gliomas after CRT.

Approach: Prospective clinical trial of 3 Tesla CEST MRI before CRT (photons and protons) and up to seven months thereafter.

Results: CEST contrasts remain unchanged in white and gray matter that received up to 60 Gray. However, CEST contrasts change inside gliomas, and the APT-weighted contrast develops differently in progressive versus non-progressive tumors.

Impact: CEST contrasts remain unchanged in normal-appearing brain tissue after radiotherapy but change inside gliomas. Based on these findings, CEST contrast changes in gliomas after radiotherapy should be considered to be tumor-specific, and may be used to support tumor response assessment.

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