| Brain Tumor: Imaging Brain Tumor Treatment & Response |
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Tuesday 21 April 2009 |
| Room 311 |
13:30-15:30 |
Moderators: |
Alberto Bizzi and Meng Law |
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13:30 |
279. |
2008 ISMRM Grant Recipient:
Systematic Evaluation of Stereotatic Radiosurgery
Effects in Metastasis and Acoustic Neurinomas Using
MRI |
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Cristian Tejos1,2,
M.E. Andia2,3, P. Besa4, J.
Lorenzoni5, A. Vieria4, L.
Meneses2,6, P. Irarrazaval1,2
1Department of Electrical Engineering,
Pontificia Universidad Catolica de Chile, Santiago,
Chile; 2Biomedical Imaging Center,
Pontificia Universidad Catolica de Chile, Santiago,
Chile; 3Radiology Department, Pontificia
Universidad Catolica de Chile, Santiago, Chile;
4Radiotherapy Department, Cancer Center,
Pontificia Universidad Catolica de Chile, Santiago,
Chile; 5Departamento de Neurocirugia,
Pontificia Universidad Catolica de Chile, Santiago,
Chile; 6Radiology Department, Pontificia
Universidad Catolica de Chile , Santiago, Chile |
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13:50 |
280. |
Apparent Diffusion Coefficient
Measures on MR Correlate with Survival in
Glioblastoma Multiforme |
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Gerard Thompson1,
John Robert Cain1, Samantha Jane Mills1,
Alan Jackson1
1Imaging Science and Biomedical Engineering,
School of Cancer and Imaging Sciences, University of
Manchester, Manchester, UK |
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Described in this work
is a method for quantifying the change in apparent
diffusion coefficient (ADC) which occurs across
tissue boundaries in glioblastoma multiforme on
diffusion-weighted imaging. The gradient of the
change in ADC moving from peri-tumoural oedema into
solid, enhancing tumour was found to correlate with
length of survival (n=18; Kendall’s tau -0.401,
p0.021; Cox’s Hazards Ratio 1.007 (1.001-1.014)
p=0.032), whereas the ADC gradient measured from
normal appearing white matter into peri-tumoural
oedema did not (n=19; Kendall’s τ 0.164, p0.327;
Cox’s Hazards Ratio 0.998 (0.998-1.008) p=0.695). |
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14:02 |
281. |
A
Fully Automated Method for Predicting Glioma Patient
Outcome from DSC Imaging; A Second Reference to
Histopathology? |
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Kyrre E. Emblem1,2,
Frank G. Zoellner3, Atle Bjornerud1,4
1Department of Medical Physics, Rikshospitalet
University Hospital, Oslo, Norway; 2The
Interventional Centre, Rikshospitalet University
Hospital, Oslo, Norway; 3Department of
Assisted Clinical Medicine, University of
Heidelberg, Mannheim, Germany; 4Department
of Physics, University of Oslo, Oslo, Norway |
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We have assessed whether
a fully automated, multi-parametric model for
predicting outcome in glioma patients from dynamic
susceptibility contrast MR imaging can be used as a
second reference to pathologic findings. Based on
automatically segmented tumor regions, 3D scatter
diagrams of cerebral blood volume as a function of Ktrans
were derived for each patient. A predictive model
based on support vector machines was used to predict
outcome in each patient using scatter diagrams and
survival status of the remaining patients. Our
results suggest that the proposed approach provides
similar diagnostic accuracy values to histopathology
when predicting patient outcome. |
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14:14 |
282. |
Acute Effects of Bevacizumab
on Glioblastoma Vascularity Assessed with DCE-MRI
and Relation to Patient Survival |
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Weiting Zhang1,
Teri N. Kreisl1, Jeff Solomon2,
Richard C. Reynolds3, Danial R. Glen3,
Robert W. Cox3, Howard A. Fine1,
John A. Butman4
1Neuro-Oncology Branch, National Cancer
Institute, NIH, Bethesda, MD, USA; 2Medical
Numerics, Inc., Germantown, MD, USA; 3National
Institute of Mental Health, NIH, USA; 4Radiology
and Imaging Sciences, Clinial Center, NIH, USA |
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DCE-MRI was used to
monitor the acute effects of Bevacizumab on
physiologic measures of tumor vascularity, such as
blood brain barrier permeability, represented as
Ktrans. In addition, we relate these to progression
free survival (PFS) and to overall survival (OS).
Bevacizumab dramatically reduces Ktrans (46%) and
enhancing tumor volume (39%) in recurrent GBMs
within 96-hour of a single dose. However, tumors in
which Bevacizumab resulted in larger decreases in
Ktrans did not demonstrate an improved survival over
those with smaller reductions in Ktrans. GBMs with
larger baseline enhancing tumor volume and greater
baseline Ktrans both predicted poorer PFS and OS. |
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14:26 |
283. |
A Composite Model of the
Parametric Response Map Predicts Survival
Independent of Radiographic Response in Patients
with High Grade Glioma |
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Craig J. Galban1,
Thomas L. Chenevert1, Daniel A. Hamstra2,
Charles R. Meyer1, Pia Sundgren1,
Christina Tsien2, Theodore S. Lawrence2,
Alnawaz Rehemtulla2, Timothy D. Johnson3,
Brian D. Ross1
1Radiology, University of Michigan, Ann Arbor,
MI, USA; 2Radiation Oncology, University
of Michigan, Ann Arbor, MI, USA; 3Biostatistics,
University of Michigan, Ann Arbor, MI, USA |
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A parametric response
map composite model of the apparent diffusion
coefficient (PRMADC) and relative
cerebral blood flow (PRMrCBF) is
predictive of treatment response in glioma patients
independent of radiographic response (RR). Perfusion
and diffusion MRI were performed on 44 patients pre
and post-treatment. Survival analysis was employed
on the population by stratifying based on RR, PRMADC,
PRMrCBF and a composite of PRMADC
and PRMrCBF (PRMADC-rCBF).
Individually, PRM was closely associated to 10 week
RR. A multivariate analysis showed a stronger
dependence on PRM, most notably PRMADC-rCBF,
than RR. This study provides a more accurate
treatment response metric for cancer patients. |
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14:38 |
284. |
R2* Response of Brain Tumors
to Hyperoxic and Hypercapnic Respiratory Challenges
at 3 Tesla |
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Andreas Müller1,
Stefanie Remmele2, Ingo Wenningmann3,
Frank Träber1, Roy König1,
Hans Clusmann4, Hannes Dahnke5,
Juergen Gieseke5, Sebastian Flacke1,
Winfried A. Willinek1, Hans H. Schild1,
Petra Mürtz1
1Department of Radiology, University Hospital
Bonn, Bonn, Germany; 2Philips Research
Europe, Hamburg, Germany; 3Department of
Anesthesiology, University Hospital Bonn, Bonn,
Germany; 4Department of Neurosurgery,
University Hospital Bonn, Bonn, Germany; 5Philips
Medical Systems, Hamburg, Germany |
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The R2* response to
hyperoxic and hypercapnic respiratory challenges is
of major diagnostic interest in oncology as it gives
insight into tissue oxygenation and vasoreactivity.
We determined the R2* response to elevated levels of
O2 and CO2 in cerebral tumors
at 3 Tesla. Different tumor regions show
characteristically altered vessel function and
reactivity. We present a robust and sensitive method
to assess oxygenation changes and vasoreactivity in
brain tumors. This additional information may
support the selection and dosage of tumor therapies
and may allow the non-invasive contrast-agent-free
monitoring of treatment response. |
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14:50 |
285. |
Functional Diffusion Maps
Applied to FLAIR Abnormal Areas Are Valuable for the
Clinical Monitoring of Recurrent Brain Tumors |
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Benjamin M. Ellingson1,2,
Mark G. Malkin1,3, Scott D. Rand1,2,
Devyani P. Bedekar1,2, Kathleen M.
Schmainda1,2
1Translational Brain Tumor Program, Medical
College of Wisconsin, Milwaukee, WI, USA; 2Department
of Radiology, Medical College of Wisconsin,
Milwaukee, WI, USA; 3Departments of
Neurology and Neurosurgery, Medical College of
Wisconsin, Milwaukee, WI, USA |
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Functional diffusion
maps (fDMs) involve calculating voxel-by-voxel
changes in diffusivity in order to spatially
localize and quantify changes in tumor cellularity.
Traditionally, fDMs are applied to contrast-enhanced
tumor regions exclusively. In the current study we
have expanded the application of fDMs to FLAIR
abnormal regions. Results suggest this technique
provides additional insight into the growth and
treatment response of both enhancing and
non-enhancing brain tumors, along with reflecting
the neurological status of the patient. |
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15:02 |
286. |
Assessment of Anti-Angiogenic
Treatment in Glioblastoma Using Arterial
Spin-Labeling and Dynamic Susceptibility Contrast
Perfusion MRI in a Phase II Trial |
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Mei-Yun Wang1,
Wei-Ting Zhang1, Poe-zhou chen1,
Thomas Benner1, Divya S. Bolar1,
Tracy T. Batchelor2, Rakesh K. Jain3,
A. Gregory Sorensen1
1Radiology, Massachusetts General Hospital,
Boston, MA, USA; 2Neurology,
Massachusetts General Hospital, Boston, MA, USA;
3Radiation Oncology, Massachusetts
General Hospital, Boston, MA, USA |
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Angiogenesis is an
essential step in the growth and spread of solid
tumor, and advances in MRI now permit detection of
the hemodynamic changes of glioblastoma after
treatment. In the current study, arterial
spin-labeling (ASL) and first-pass dynamic
susceptibility contrast (DSC) perfusion MRI were
used to assess the treatment effect of an anti-angiogenic
agent AZD2171, a pan-VEGF receptor tyrosine kinase
inhibitor, in a phase-II clinical trial. Our results
suggest ASL is almost as sensitive as DSC in
assessing rCBF changes of tumor and the tumor
vascular normalization and reversal after
anti-angiogenesis treatment. |
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15:14 |
287. |
Intravoxel Water Diffusion
Heterogeneity of Human High-Grade Gliomas |
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Thomas Kwee1,
Craig Galban1, Marko Ivancevic1,2,
Pia Sundgren1, Christina Tsien3,
Larry Junck4, Benjamin Hoff1,
Charles Meyer1, Brian Ross1,
Thomas Chenevert1
1Department of Radiology, University of
Michigan, Ann Arbor, MI, USA; 2Philips
Healthcare, Cleveland, OH, USA; 3Department
of Radiation Oncology, University of Michigan, Ann
Arbor, MI, USA; 4Department of Neurology,
University of Michigan, Ann Arbor, MI, USA |
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Diffusion-weighted
signal decay of brain tissue is multi-exponential
due to the presence of multiple intravoxel proton
pools (IPPs) with different diffusion coefficients.
This study investigated the intravoxel water
diffusion heterogeneity (IDWH) of human high-grade
gliomas (N=20), using the stretched-exponential
model. IDWH was significantly higher in high-grade
gliomas than in normal brain tissue, which
potentially offers a new method for assessing tumor
extent and evaluating therapeutic response.
Correlation between tumor IDWH and overall tumor
diffusion coefficient was strongly negative,
suggesting that highly cellular tumors contain a
lower number of distinct IPPs, while cystic/necrotic
tumors contain a higher number of distinct IPPs. |
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