TRADITIONAL POSTER - ismrm

Poster Sessions
2202. Assessment of Diffusion Parameters in Scans Prior to Progression in GBM Patients Following Anti-
Angiogenic Therapy
Laleh Jalilian 1 , Emma Essock-Burns 1,2 , Susan M. Chang 3 , Soonmee Cha 3,4 , Sarah J. Nelson, 1,4
1 Surbeck Laboratory of Advanced Imaging, Department of Radiology, University of California, San Francisco, San Francisco, CA,
United States; 2 UCSF/UCB Graduate Group in Bioengineering, University of California, San Francisco, San Francisco, CA, United
States; 3 Department of Neurological Surgery, University of California, San Francisco, University of California, San Francisco, San
Francisco, CA, United States; 4 Department of Radiology, University of California, San Francisco, University of California, San
Francisco, San Francisco, CA, United States
Diffusion-weighted Imaging (DWI) is an important adjunct to standard imaging in the management of GBM patients receiving anti-angiogenic treatments. In
this study, ADC values were obtained for a) areas on preprogression scans that ultimately progressed to new contrast-enhancement on progression scans
(NEW_CEL), and b) new FLAIR abnormality on preprogression scans with exclusion of areas of contrast enhancement and areas that progress to new
contrast-enhancement on progression scans (T2ALL_M). Results demonstrated increasing ADC values in NEW_CEL but no change in T2ALL_M in scans
prior to progression. Clinical implications include interpreting new FLAIR abnormality as a consequence of anti-angiogenic treatment alone.
2203. Comparison of Glioma Sub-Populations Using In-Vivo ADC Values and Ex-Vivo 1 H HR-MAS
Spectroscopy
Adam Elkhaled 1 , llewellyn Jalbert 1 , Hikari Yoshihara 1 , Gaby Bourne 1 , Colleen Cloyd 1,2 , Joanna Phillips 3 ,
Soonmee Cha 1 , Susan M. Chang 4 , John Kurhanewicz 1,5 , Radhika Srinivasan 1 , Sarah J. Nelson 1,5
1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States;
2 School of Pharmacy, University of California, San Francisco, United States; 3 Department of Pathology, University of California, San
Francisco, San Francisco, CA, United States; 4 Department of Neurological Surgery, University of California, San Francisco;
5 Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, United States
Characterization of glioma recurrence and grade transformation has remained elusive. Image-guided biopsies from glioma patients were evaluated using
pathology, in-vivo ADC, and ex-vivo proton HR-MAS spectroscopy. Newly diagnosed and recurrent grade IV tissue samples were found indistinguishable
from one another. A comparison of recurrent grade IV to recurrent low-grade glioma revealed a significant difference in [myo-inositol] and [creatine];
recurrent low-grades which had upgraded displayed higher total choline compared to non-upgraded and high-grade glioma; the [myo-I]/[total choline] ratio
differentiated non-upgraded low-grades from all other cohorts. ADC values demonstrated an inverse relationship with tumor grade and negative correlation
with glutathione.
2204. Finding Early Prognostic Marker from 3D 1 H-MRSI and Diffusion Tensor Imaging for Newly-
Diagnosed GBM Patients Receiving Radiation, Temozolomide and PKC Inhibitor
Ilwoo Park 1,2 , Adam Elkhaled 2 , Achuta Kadambi 2 , Inas Khayal 2 , Nicholas Butowski 3 , Susan M. Chang 3 ,
Sarah J. Nelson 1,2
1 Joint Graduate group in Bioengineering, University of California San Francisco/Berkeley, San Francisco, CA, United States;
2 Surbeck Laboratory of Advanced Imaging, Department of Radiology and Biomedical Imaging, University of California San
Francisco, San Francisco, CA, United States; 3 Department of Neurological Surgery, University of California San Francisco, San
Francisco, CA, United States
The purpose of this study was to use 3D 1 H MR Spectroscopic Imaging (MRSI) and diffusion tensor imaging (DTI) to develop early prognostic markers for
GBM patients undergoing radiation, temozolomide and PKC inhibitor. Twenty-nine patients with newly diagnosed GBM were examined using a 3T MR
scanner. Conventional anatomical imaging parameters could not distinguish between progression groups at baseline or 1 month. Parameters derived from
MRSI and DTI provided information at baseline and early follow-up examinations that may be valuable in predicting the time-to-progression for patients
with GBM.
2205. Longitudinal MRSI Study in Newly Diagnosed Glioblastoma Multiforme
Yan Li 1 , Janine M. Lupo 1 , Soonmee Cha 1 , Susan Chang 2 , Sarah J. Nelson 1,3
1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States; 2 Department of
Neurological Surgery, University of California, San Francisco, CA, United States; 3 Department of Bioengineering & Therapeutic
Sciences, University of California, San Francisco, CA, United States
Glioblastoma Multiforme (GBM) is the most common and malignant type of primary brain tumor, resulting in a median survival of approximately one year.
Our study of 18 patients with GBM indicated that metabolic abnormalities more accurately reflect the underlying tumor burden. We found that the Cho to
NAA index (CNI) values in the contrast-enhancing lesion (CEL) are elevated at 2 months prior to progression while having less changes in CEL volume at
that time. Patients who have a CEL volume with high CNI values are more likely to progress compared with those who have with smaller CEL volume and
lower CNI values. We also observed that the regions with high CNI values outside the CEL region could subsequently become enhancing.
2206. 31P and 1H Spectroscopic Imaging of Recurrent Malignant Gliomas
Ulrich Pilatus 1 , Joerg Magerkurth 1 , Oliver Bähr 2 , Joachim Steinbach 2 , Elke Hattingen 1
1 Institute of Neuroradiology, University Hospital, Goethe-University, Frankfurt, Germany; 2 Senckenbergisches Institute of
Neurooncology, University Hospital, Goethe University
Proton and 31P MRSI was performed on human malignant recurrent gliomas in order to provide in vivo analysis of membrane metabolism and neuronal
brain damage (tNAA). Phosphorylated components in the membrane metabolism showed clear changes indicating a shift to proliferating cell fractions.
While the increase in the phosphocholine/glycerophosphocholine ratio in tumor tissue did not reach significance (p=0.07) the respective ratio for the