TRADITIONAL POSTER - ismrm

Poster Sessions
2166. Perfusion MRI Fractional Tumor Bulk Mapping: Correlation with Multiple Stereotactic Biopsies in
Recurrent GBM
Leland S. Hu 1,2 , Seban Liu 3 , Dilini S. Pinnaduwage 4 , Kris A. Smith 5 , Peter Nakaji 5 , Amylou C. Dueck 6 ,
Todd Jensen 7 , Jennifer M. Eschbacher 8 , Joseph E. Heiserman 2 , John P. Karis 2 , Josef Debbins 3 , Burt G.
Feuerstein 9 , Kathleen M. Schmainda 10 , Leslie C. Baxter 3
1 Radiology, Mayo Clinic, Arizona, Scottsdale, AZ, United States; 2 Radiology, Neuroradiology Section, St. Joseph's Hospital - Barrow
Neurological Institute, Phoenix, AZ, United States; 3 Keller Center for Imaging Innovation, St. Joseph's Hospital - Barrow
Neurological Institute, Phoenix, AZ, United States; 4 Radiation Oncology, University of California - San Francisco, San Francisco, CA,
United States; 5 Neurosurgery, St. Joseph's Hosptial - Barrow Neurological Institute, Phoenix, AZ, United States; 6 Biostatistics, Mayo
Clinic, Arizona, Scottsdale, AZ, United States; 7 Imaging Biometrics, LLC; 8 Neuropathology, St. Joseph's Hospital - Barrow
Neurological Institute, Phoenix, AZ, United States; 9 Neuro-Oncology, St. Joseph's Hospital - Barrow Neurological Institute, Phoenix,
AZ, United States; 10 Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
We present methods to calculate ‘Perfusion MRI (pMRI) fractional tumor bulk,’ which quantifies and spatially localizes areas of tumor recurrence within
non-specific contrast enhanced (CE) MRI lesions. We correlate these measures with the percentage, or fraction, of tissue samples histopathologically
diagnosed as tumor, in a group of recurrent Glioblastoma Multiforme (GBM) patients undergoing multiple stereotactic biopsies.
2167. Pseudo-Tumoral Response of Glioblastoma to Anti-Angiogenic Treatment Prematurely Revealed by
Using Arterial Spin-Labeling (ASL) Perfusion MRI and Susceptibility Weighted Imaging (SWI).
Slim Fellah 1 , Yann Lefur 1 , Elisabeth Soulier 1 , Céline Boucard 2 , Sylviane Confort-Gouny 1 , Olivier Chinot 2 ,
Patrick J. Cozzone 1 , Jean-Philippe Ranjeva 1 , Virginie Callot 1
1 Centre de Résonance Magnétique Biologique et Médicale (CRMBM), CNRS UMR 6612, Faculté de Médecine, Marseille, France;
2 Unité de Neuro-Oncologie, CHU Timone, Marseille, France
Anti-angiogenics have become part of Glioblastoma therapeutic protocol. However pseudo-response followed by a critical recurrence may be observed.
Non-responders thus need to be prematurely identified. However current imaging criteria are insufficient or late, new MR markers should therefore be
investigated. In this preliminary study, we used a multimodal protocol including particularly ASL and SWI, which provide vascular information. A few
weeks after the beginning of the treatment, FLAIR and post-contrast T1-WI showed partial response whereas perfusion MRI and SWI demonstrated
hyperperfusion and vascularization increase. The parameters derived from such sequences should thus be considered as early indicators of tumor evolution.
2168. Longitudinal Monitoring of Low-Grade Glioma Transformation: A Fully-Automatic Method Using
Quantitative DSC-MRI
Kyrre E. Emblem 1,2 , Paulina Due-Tonnessen 1,3 , Inge A. Rasmussen Jr 1 , Atle Bjornerud 2,4
1 The Interventional Centre, Rikshospitalet, Oslo University Hospital, Oslo, Norway; 2 Department of Medical Physics, Rikshospitalet,
Oslo University Hospital, Oslo, Norway; 3 Clinic for Imaging- and Intervention, Rikshospitalet, Oslo University Hospital, Oslo,
Norway; 4 Department of Physics, University of Oslo, Oslo, Norway
In this study, a fully-automatic method for longitudinal monitoring of low-grade glioma transformation by quantitative dynamic susceptibility contrast
(DSC) MRI was evaluated and compared to conventional criteria for malignant glioma progression. Thirteen patients were imaged at least three times, with
an average time between two consecutive MR exams of 283 days. Our results suggest that the fully-automatic method provides a sensitive marker for tumor
progression at an early stage compared to conventional imaging criteria. Also, the quantitative tumor analysis and monitoring of baseline perfusion values in
unaffected brain tissue, allows inter- and intra-patient comparisons across MR machines and institutions.
2169. Can Susceptibility-Weighted Imaging Determine Response to Combined Anti-Angiogenic, Cytotoxic,
and Radiation Therapy in GBM Patients?
Janine M. Lupo 1 , Soonmee Cha 1 , Emma Essock-Burns 1,2 , Nicholas Butowski 3 , Sarah J. Nelson 1,2
1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States;
2 Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, United States;
3 Department of Neurosurgery, University of California, San Francisco, San Francisco, CA, United States
This study investigated whether the unique contrast provided by SWI, which highlights heterogeneity within the post-gadolinium contrast enhancing brain
tumor lesion, can predict response to treatment. Nineteen patients with newly-diagnosed GBM were imaged prior to beginning anti-angiogenic, cytotoxic,
and radiation therapy and followed until progression. The volume of SWI hypointense signal within the contrast-enhancing lesion was dramatically higher
in patients who progressed after 1 year post-therapy compared to patients who progressed within 6 months of initiating treatment. These findings suggest
that SWI could be advantageous for determining which patients would be the best candidates for adjuvant anti-angiogenic therapeutic strategies.
2170. Comparison of DSC-Derived Perfusion Parameters in Response to Conventional Therapy or Adjuvant
Anti-Angiogenic Therapy in Patients Newly-Diagnosed with GBM
Emma Essock-Burns 1,2 , Yan Li 1 , Janine M. Lupo 1 , Mei-Yin Polley 3 , Nicholas Butowski 3 , Susan M. Chang 3 ,
Soonmee Cha, 1,3 , Sarah J. Nelson 1,4
1 Department of Radiology and Biomedical Imaging, UC San Francisco, San Francisco, CA, United States; 2 Joint Graduate Group in
Bioengineering, UC San Francisco/UC Berkeley , San Francisco, CA, United States; 3 Department of Neurological Surgery, UC San
Francisco, San Francisco, CA, United States; 4 Department of Bioengineering and Therapeutic Sciences, UC San Francisco, San
Francisco, CA, United States
Adjuvant anti-angiogenic therapy may alter the presentation of contrast enhancement creating a clinical need for new methods of evaluating response.
Dynamic susceptibility contrast enhanced imaging was used to assess vascular changes of patients newly diagnosed with GBM in response to either