Abstract #2389

Quantitative Analysis of Dynamic CEST Images to Evaluate Pseudoresponse of Bevacizumab Treatment

Keyi Chai^1,2, Puyang Wang¹, Jingpu Wu^1,3, Zongpai Zhang¹, Karisa Schreck⁴, Matthias Holdhoff⁵, David Kamson⁴, Lindsay Blair⁴, John Laterra⁴, Jinyuan Zhou¹, and Shanshan Jiang¹

¹Department of Radiology, Johns Hopkins University, Baltimore, MD, United States, ²Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States, ³Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, United States, ⁴Department of Neurology, Johns Hopkins University, Baltimore, MD, United States, ⁵Department of Oncology, Johns Hopkins University, Baltimore, MD, United States

Synopsis

Keywords: Tumors (Post-Treatment), Treatment Response, Bevacizumab, Glioma, CEST/APT

Motivation: Bevacizumab is widely used for treating high-grade gliomas, yet conventional MRI sequences often show limitations in effectively monitoring the therapeutic response.

Goal(s): The study aims to apply structural and advanced MRI techniques (APTw, CEST@2ppm, T1 and T2 mapping) to assess changes in tumor and surrounding edema, focusing on distinguishing true treatment effects from pseudoresponse.

Approach: We developed a robust quantitative approach for analyzing follow-up scans of patients. Response maps and statistical comparisons were performed to evaluate therapeutic effects.

Results: APTw and CEST@2ppm are more accurate in monitoring tumor, outperforming T1 and T2 maps in identifying pseudoresponse, and thus improving diagnostic accuracy.

Impact: This study provides a practical approach for robust and accurate evaluation of Bevacizumab treatment, demonstrating the superiority of CEST imaging in identifying pseudoresponse. It shows potential to complement existing clinical protocols, enabling more precise diagnoses for glioma patients.

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