| Imaging in Brain Tumor - Diagnosis |
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Monday 20 April 2009 |
| Room 311 |
16:30-18:30 |
Moderators: |
Micheal D. Phillips and Brian D. Ross |
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16:30 |
140. |
Simultaneous MR and PET
Imaging of Human Brain Tumors Using an Integrated MR-PET
Scanner |
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Ciprian Catana1, Thomas Benner1,
Andre van der Kouwe1, Dominique L.
Jennings1, Michael Hamm2, Poe-Jou
Chen1,3, Ovidiu C. Andronesi1,
Elizabeth R. Gerstner4, Larry Byars5,
Christian Michel5, Josef Pfeuffer2,
Matthias Schmand5, Bruce R. Rosen1,
A. Gregory Sorensen1
1MGH, Radiology, A.A. Martinos Center for
Biomedical Imaging, Charlestown, MA, USA; 2Siemens
Medical Solutions USA Inc., Charlestown, MA, USA;
3Nuclear Science and Engineering,
Massachusetts Institute of Technology, Cambridge,
MA, USA; 4Massachusetts General Hospital,
Boston, MA, USA; 5Siemens Medical
Solutions USA Inc., Knoxville, TN, USA |
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Magnetic
resonance imaging (MRI) and positron emission
tomography (PET) are widely used imaging
technologies with both clinical and biomedical
research applications. An MRI-compatible PET scanner
prototype has been built for brain applications that
allows data from both modalities to be acquired
simultaneously. In this work, we demonstrate the
feasibility of this combined system for performing
simultaneous MR-PET data acquisition in brain tumor
patients, including dynamic data acquisition. |
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16:42 |
141. |
Molecular
Imaging of High-Grade Brain Tumors Using Endogenous
Protein and Peptide-Based Contrast |
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Zhibo Wen1,
Shuguang Hu2, Fanheng Huang1,
Peter C.M. van Zijl3,4, Jinyuan Zhou3,4
1Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou,
Guangdong, China; 2Philips Healthcare,
Guangzhou, Guangdong, China; 3Department
of Radiology, Johns Hopkins University, Baltimore,
MD, USA; 4F.M. Kirby Research Center for
Functional Brain Imaging, Kennedy Krieger Institute,
Baltimore, MD, USA |
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Amide
proton transfer (APT)-MRI is a chemical exchange
saturation transfer (CEST) based approach in which
the amide protons of endogenous proteins and
peptides are irradiated to accomplish detection
using the water signal. In this abstract, the APT
approach was added to standard brain MRI for tumor
patients at 3T. The initial results (n = 4) show
that APT imaging can enhance noninvasive
identification of tissue heterogeneity in high grade
brain tumors. |
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16:54 |
142. |
Random
Walk Model for Predicting Patterns of Microscopic
Glioma Spread Using DTI: A Prospective Study |
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AnithaPriya Krishnan1, Delphine Davis2,
Paul Okunieff3, Walter O'Dell4
1Department of Biomedical Engineering,
University of Rochester, Rochester, NY, USA; 2Departments
of Imaging Sciences and Radiation Oncology,
University of Rochester, Rochester, NY, USA; 3Department
of Radiation Oncology, University of Rochester,
Rochester, NY, USA; 4Departments of
Radiation Oncology and Biomedical Engineering,
University of Rochester, Rochester, NY, USA |
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Current
methods for determining the treatment margins needed
to encompass microscopic tumor spread for
Stereotactic Radiotherapy (SRT) are inadequate as
recurrences often occur at/near the boundary of the
treatment margin. If our hypothesis that paths of
elevated water diffusion along white matter tracts
provide a preferred route for migration of tumor
cells is correct, then future SRT plans would be
modified accordingly to reduce the incidence of
recurrence. Areas of high cell concentration as
prospectively predicted by our random walk model
based on MR DTI matched the subsequent appearance of
secondary tumors in patients undergoing SRT for
high-grade gliomas. |
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17:06 |
143. |
Contrast-Enhanced Three-Dimensional Whole-Brain
Black-Blood Imaging for Efficient Detection of Small
Metastases |
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Jaeseok
Park1, Eung Yeop Kim1,2
1Department of Radiology and Research
Institute of Radiological Science, Yonsei University
College of Medicine, Seoul, Korea; 2Brain
Korea 21 Project for Medical Science, Yonsei
University College of Medicine, Seoul, Korea |
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Contrast-enhanced three-dimensional T1-weighted MR
imaging based on
magnetization-prepared-rapid-gradient-recalled-echo
(MP-RAGE), has been shown to be sensitive for the
detection of small brain metastases due to the
T1-shortening effect of contrast agent. However,
since contrast agent remains in blood and tumors,
and thus increases signal intensity in both parts,
it is challenging to accurately detect the brain
tumors using the conventional method. The purpose of
this work was to develop a novel contrast-enhanced
3D whole-brain black-blood imaging method which
enhances the signal intensity of brain tumor while
selectively suppressing that of blood, and thus
enhance the accuracy of diagnosis for small brain
metastases. |
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17:18 |
144. |
New
Diffusion Restriction Precedes the Development of
Enhancing Tumor in Glioblastomas |
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Ajay
Gupta1,2, Sahil Sood1,2,
Robert Young2, Sasan Karimi2,
Zhigang Zhang2, Andrei Holodny2
1Weill Cornell Medical College, New York
City, NY, USA; 2Memorial Sloan Kettering
Cancer Center, New York City, NY, USA |
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Assessment of glioma progression vs. stability or
response has traditionally relied on typical MR
imaging characteristics, such as changes in tumor
size and extent of contrast enhancement. Finding
earlier imaging biomarkers of glioma progression can
have an enormous impact on clinical treatment
decision-making. In this study, we demonstrate that
in a subset of patients with GBM, new nonenhancing
regions of restricted diffusion can predict the
future development of enhancing tumor and tumor
progression. This information may therefore be
useful in guiding clinical decision making and
treatment changes prior to the development of
abnormal tumoral enhancement. |
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17:30 |
145. |
The Value
of MRS Detectable Lipids as Prognostic Markers in
Paediatric Brain Tumours |
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Martin
Wilson1,2, Carole Cummins2,
Leslie MacPherson2, Yu Sun2,3,
Kal Natarajan2, Nigel P. Davies2,
Theo N. Arvanitis2,3, Risto A. Kauppinen4,
Andrew C. Peet1,2
1Cancer Sciences, University of
Birmingham, Birmingham, West Midlands, UK; 2Oncology,
Birmingham Children's Hospital Foundation Trust,
Birmingham, West Midlands, UK; 3School of
Electronic, Electrical & Computer Engineering,
University of Birmingham, Birmingham, West Midlands,
UK; 4Dartmouth Medial School, Dartmouth
College, Hanover, NH, USA |
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Brain
tumours are an important cause of childhood
morbidity and mortality and new approaches to brain
tumour assessment and therapy are a priority for
cancer research. In this study, short-echo time
single voxel in-vivo 1H MRS was used to
investigate 121 pre-treatment peadiatric brain
tumour cases. Patients were followed-up for period
of up to 5 years and lipids were found to be
predictive of long term survival. |
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17:42 |
146. |
Possibilistic Classification of Brain Tumors by MRS
Based on Functional Data Analysis and Subpattern
Discovery |
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Juan M
García-Gómez1, Irene Epifanio2,
Margarida Julià-Sapé3,4, Daniel Monleón3,5,
Javier Vicente1, Salvador Tortajada1,
Elies Fuster1, Angel Moreno-Torres6,
Andrew Peet7,8, Franklyn Howe9,
Bernardo Celda3,10, Carles Arús3,4,
Montserrat Robles1
1ITACA-IBIME, Universidad Politécnica de
Valencia, Valencia, Spain; 2Departament
de Matemàtiques, Universitat Jaume I, Valencia,
Spain; 3CIBER de Bioingeniería,
Biomateriales y Nanomedicina, Spain; 4Departament
de Bioquímica i Biologia Molecular, Universitat
Autònoma de Barcelona, Cerdanyola del Vallès, Spain;
5Fundación de Investigación del Hospital
Clínico Universitario de Valencia, Valencia, Spain;
6Research Department, Centre Diagnòstic
Pedralbes, Barcelona, Spain; 7University
of Birmingham, Birmingham, UK; 8Birmingham
Children’s Hospital, Birmingham, UK; 9St
George’s Hospital Medical School, London, UK;
10Departamento de Química-Física, Universitat
de València, Valencia, Spain |
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When
designing a Clinical Decision Support System for
Brain Tumors based on MRS, it would be of interest
to deal with any prospective case. Besides, due to
the possible acquisition artifacts, baseline
differences, or molecular artifacts in MRS-SV, the
in-vivo MRS pattern may be heterogeneous
within each diagnostic class. We present a
possibilistic classifier evaluated on the largest
multicenter database of MRS of brain tumors
available to us based on FDA and subpattern
analysis. It overperformed the classical approaches.
The detected in-vivo MR spectral pattern
subtypes could be useful for the interpretation of
the natural heterogeneity of the diagnoses. |
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17:54 |
147. |
Development of an MR Spectroscopic Index to
Differentiate Tumor from Treatment Induced Gliosis |
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Radhika
Srinivasan1, Jan Wooten1,
Jason C. Crane1, Soonmee Cha11,
Suzanne Chang1, Scott Vandenberg1,
John Kurhanewicz1, Sarah J. Nelson1
1UCSF, San Francisco, CA, USA |
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The goal
of this study was to identify MR spectroscopic (MRS)
markers that are likely to be able to differentiate
active tumor from treatment induced gliosis. This is
an important problem because while tumor regions
should be included in follow-up treatment plans,
regions represented by gliosis should be left
untouched since these areas represent areas of
normal brain that are influenced by treatment.
Typically high choline levels are used to indicate
tumor presence. The challenge in differentiating
tumor from gliosis using this metric is that both of
them could result in elevated levels of choline. To
evaluate strategies to resolve this ambiguity we
first determine the characteristic MR Spectroscopic
markers that differentiate tumors from gliosis using
High Resolution Magic Angle Spectroscopy (HR-MAS) of
samples that are confirmed to belong to either tumor
or gliosis using histopathology. The specific
markers derived from this study are evaluated by
ex-vivo HR-MAS of biopsies from within tumor
regions in patients with newly diagnosed GBM.
Finally these markers are evaluated against known MR
markers of tumor presence from in-vivo 3T MR
data. Following these studies the development of a
suitable MRS index that has the potential to
differentiate tumor from gliosis will be presented. |
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18:06 |
148. |
Targeted
Use of 1H-MRS Is as Accurate as Histology in the
Diagnosis of Glioblastoma Multiforme |
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Greg
Fellows1, Alan James Wright2,
Naomi Sibtain3, Philip Rich4,
Kirstie S. Opstad2, Dominick J.O McIntyre5,
Brian Anthony Bell1, John Griffiths5,
Franklyn Arron Howe6
1Academic Neurosurgery Unit, St. George's
University of London, London, UK; 2Basic
Medical Sciences, St. George's University of London,
London, UK; 3Neuroradiology, King’s
College Hospital NHS Trust, London, UK; 4Neuroradiology,
St. George's Hospital NHS Trust, London, UK; 5CRUK
Cambridge Research Institute, Cambridge, UK; 6Cardiac
and Vascular Sciences, St. George's University of
London, London, UK |
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Oncological practice requires histopathological
confirmation of glioblastoma multiforme (GBM) prior
to radiotherapy. If lesion location or patient
health precludes surgical debulking prior to
treatment, then 1H MRS could provide a clinically
useful alternative diagnosis to biopsy. 89 patients’
with 1H-MRS, CT and MRI were evaluated
neuroradiologically and spectroscopically. Of
patients selected on clinical and neuroradiological
grounds for diagnostic biopsy alone, there was 100%
concordance between a spectroscopy and
histopathological diagnosis of GBM. We propose a 1H
MRS protocol for accurate diagnosis of a subset of
GBM patients for which a surgical procedure and
treatment delay could be avoided. |
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18:18 |
149. |
Sodium MRI
and 1H MRS in the Diagnosis and Monitoring of
Primary Brain Tumors |
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Fernando
Emilio Boada1, Yongxian Qian1,
Denise Davis1, Frank Lieberman2,
Ronald Hamilton3, Arlan Mintz4,
Eric Schwartz1
1Radiology, University of Pittsburgh,
Pittsburgh, PA, USA; 2Neuro-oncology,
University of Pittsburgh, Pittsburgh, PA, USA;
3Neuropathology, University of Pittsburgh,
Pittsburgh, PA, USA; 4Neurosurgery,
University of Pittsburgh, Pittsburgh, PA, USA |
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In this
abstract we perform concurrent proton MRS and sodium
MRI of primary brain tumor at 3 Tesla and evaluate
the use of the two techniques with regards to ease
of use, reproducibility and the correlation between
their findings across tumor types.
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