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Abstract #2402

Dose dependency of MRI changes following pre-operative radiotherapy in glioblastoma; volumetric, ASL and APT changes

Aisling E Fothergill1,2, Mueez Waqar2,3, Alina Sovetkina4, Shefali Parikh5, David Higgins6, Owen Thomas2,4, David Coope2,3, Ibrahim Djoukhadar2,4, Gerben Borst5, and Laura M Parkes1,2
1Division of Psychology, Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom, 2Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Manchester, United Kingdom, 3Department of Academic Neurological Surgery, Salford Royal Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom, 4Department of Radiology, Salford Royal Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom, 5Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom, 6Philips, Farnborough, United Kingdom

Synopsis

Keywords: Tumors (Post-Treatment), Tumors, APT, Arterial Spin Labelling, Radiotherapy, Quantitative Imaging

Motivation: Prognosis for people with glioblastoma remains poor, pre-operative radiotherapy may improve outcome.

Goal(s): Determine early changes after pre-operative radiotherapy using T1w+contrast, FLAIR, Arterial Spin Labelling (ASL) and Amide Proton Transfer-weighted (APTw) MRI to better understand early impact of radiotherapy on tumours.

Approach: Assess hyperintense-FLAIR, enhancing and necrotic volume change, and change in perfusion and MTRasym after pre-operative radiotherapy. Assess association with radiotherapy dose received.

Results: Hyperintense-FLAIR volume decreases in 8 out of 9 patients 1-2 days after radiotherapy in a dose-dependent manner. Perfusion showed dose-dependent increase in both the enhancing and hyperintense-FLAIR regions and MTRasym showed dose-dependent decrease in the hyperintense-FLAIR region.

Impact: This study assesses early changes after pre-operative brain irradiation in glioblastoma. We show that hyperintense-FLAIR volume reduces, perfusion increases and MTRasym decreases in a dose-dependent manner within 1-2 days of radiotherapy, providing potentially valuable measures to track radiotherapy response.

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Keywords