Abstract #2539

Combined Dynamic Contrast-Enhanced and Dynamic Susceptibility-Contrast MRI in Differentiating Treatment-related Effects from Progression

Jiayu Xiao¹, Yang Chen^1,2, Songrui Wang³, Steven Cen¹, Frances Chow⁴, David Tran⁴, Jason Ye⁵, Mark Shiroishi⁶, Gabriel Zada⁷, Eric Chang⁵, and Zhaoyang Fan^1,2

¹Radiology, University of Southern California, Los Angeles, CA, United States, ²Biomedical Engineering, University of Southern California, Los Angeles, CA, United States, ³Electrical Engineering, University of Southern California, Los Angeles, CA, United States, ⁴Oncology, University of Southern California, Los Angeles, CA, United States, ⁵Radiation Oncology, University of Southern California, Los Angeles, CA, United States, ⁶Radiology, Los Angeles General Medical Center, Los Angeles, CA, United States, ⁷Neurosurgery, University of Southern California, Los Angeles, CA, United States

Synopsis

Keywords: Tumors (Post-Treatment), DSC & DCE Perfusion

Motivation: The differential diagnosis of true tumor progression and treatment-related effects using conventional MRI remains challenging in primary or secondary brain tumors after treatment.

Goal(s): To investigate whether combined DCE and DSC MRI can improve diagnostic accuracy.

Approach: We enrolled patients with treated glioblastoma or brain metastases who showed enlarged enhancing lesion in the treated bed. DCE and DSC sequences were included in their standard brain MRI scans. We calculated key parameters from DCE and DSC images and analyzed the diagnostic accuracy individually and in combination.

Results: K^trans_mean outperformed other imaging biomarkers. A combined K^trans_mean and rCBV_mean achieved excellent diagnostic accuracy.

Impact: Combined DCE and DSC demonstrated excellent diagnostic accuracy in differentiating treatment-related effects and brain tumor progression when an enlarged enhancing lesion was first spotted on MRI. It could allow physicians to early evaluate treatment response and make decisions accordingly.

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