Guillaume Thibault¹, Alina Tudorica², Aneela Afzal², Stephen Chui², Arpana Naik², Megan Troxell³, Kathleen Kemmer², Karen Oh², Nicole Roy², Megan Holtorf², Wei Huang², and Xubo Song^2
1BME, OHSU, Portland, OR, United States, ²OHSU, Portland, OR, United States, ³OHSU, portland, OR, United States

36 breast cancer patients underwent research DCE-MRI before and after one cycle of neoadjuvant chemotherapy.  3D tumor imaging texture features were extracted from parametric maps of quantitative pharmacokinetic (PK) and semi-quantitative DCE-MRI parameters, and correlated with pathologically measured post-therapy residual cancer burden (RCB).  Texture features from quantitative PK parameters were found to be more useful than those from semi-quantitative metrics for early prediction of therapy response, while the features from the SSM PK parameters were superior to the SM counterparts for prediction of response.

Shunan Che¹, Chunwu Zhou¹, Xinming Zhao¹, Jing Li¹, and Bing Wu^2
1department of radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China, People's Republic of, ²GE Healthcare MR Research China, Beijing, China, People's Republic of

Purpose: to explore whether IVIM can determine pre-treatment differences or monitor early response in breast cancer patients receiving NAC. Materials and Methods: thirty-six patients examined with multiple-b DWI were divided into MHR and NMHR groups. Parameters between MHR and NMHR groups were compared. Results: the D and f value at the baseline and mid-treatment of NAC showed significantly differences between MHR and NMHR. ?D and ?f were significantly higher in MHR than in NMHR. Conclusion: the D and f value showed potential value in the pre-treatment prediction and early response monitoring to NAC in local advanced breast.

Deborah Sharon Honrado Guest¹, Craig Galbán¹, Gary Luker¹, Thomas Chenevert¹, Benjamin Lemasson², Robin Johannes Marius Navest³, Klaas Nicolaij³, and Brian Ross^1
1Radiology, University of Michigan, Ann Arbor, MI, United States, ²Institut des Neurosciences, Université Grenoble Alpes, Grenoble, France, ³Department of Biomedical Engineering, Technische Universiteit Eindhoven, EINDHOVEN, Netherlands

This study investigates the possibility of adapting the PRM method for use with normalized FLAIR images to predict OS and TTP for indication of tumor recurrence. Glioma patients were separated into non-responders and responders to treatment. Voxels present in the union of the VOIs for the rFLAIR images were used to evaluate the PRM_rFLAIR values and categorize patients into groups based on changes in signal intensity. This study shows that predicting TTP and OS is achievable using PRM with rFLAIR maps for patients treated with TMZ/IR and provides the first demonstration of quantifying FLAIR signals in patients over time.  

Hatef Mehrabian^1,2, Kimberly L Desmond³, Arjun Sahgal^1,4, Hany Soliman^1,4, Anne L Martel^1,2, and Greg J Stanisz^1,2
1Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada, ²Medical Biophysics, University of Toronto, Toronto, ON, Canada, ³Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, ON, Canada, ⁴Radiation Oncology, Odette Cancer Centre, Toronto, ON, Canada

Targeted radiation treatments are expected to induce DNA damage in tumor cells which leads to apoptosis. Apoptotic cells experience an increase in cell membrane permeability and surface-to-volume ratio, both of which result in increased water exchange rate between intracellular and extracellular compartments.

Using a three compartment relaxation model we demonstrate that early changes in intracellular-extracellular water exchange correlated well with tumor volume change one-month post-treatment. Moreover, when the water exchange rate was combined with early tumor volume change and was employed in a classifier, the patients with partial response and progressing disease could be identified with a very high accuracy.

David Aramburu Nuñez^1,2, Antonio Lopez Medina³, Moises Mera Iglesias⁴, Francisco Salvador Gomez⁵, Vaios Hatzoglou⁶, Ramesh Paudyal¹, Alfonso Calzado², Joseph O Deasy¹, Amita Shukla-Dave⁷, and Victor M Muñoz^8
1Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ²Department of Radiology, Complutense University, Madrid, Spain, ³Medical Physics & Radiological Protection, Galaria - Hospital do Meixoeiro – Complexo Hospitalario Universitario de Vigo, Vigo, Spain, ⁴Medical Physics, Oncoserv, Santiago de los Caballeros, Dominican Republic, ⁵Medical Physics and Radiological Protection, Galaria - Hospital do Meixoeiro – Complexo Hospitalario Universitario de Vigo, Vigo, Spain, ⁶Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ⁷Medical Physics & Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ⁸Radiation Oncology, Galaria - Hospital do Meixoeiro – Complexo Hospitalario Universitario de Vigo, Vigo, Spain

Biologically guided radiotherapy needs an understanding of how different functional imaging techniques interact and link together. DW-MRI and 18F FDG-PET techniques were used in this study for achieving this objective. 5 HPV-, HNSCC patients underwent 20 DW-MRI and 10 18F-FDG-PET/CT scans before and during radiation therapy. ADC maps derived from DW-MRI and SUV values from 18F-FDG were used for evaluating tumor response. The initial evaluation of the preliminary results suggests that in these solid tumors cellularity is inversely proportional to the glucose metabolic uptake. The survival status and functional metrics show different trends for NED, AWD and DOD. 

Lei Tang¹, Jian Li², Ying-Shi Sun¹, Xiao-Ting Li¹, Zi-Yu Li³, Xiao-Yan Zhang¹, and Lin Shen ^2
1Radiology, Peking University Cancer Hospital & Institute, Beijing, China, People's Republic of, ²GI medicine, Peking University Cancer Hospital & Institute, Beijing, China, People's Republic of, ³GI surgery, Peking University Cancer Hospital & Institute, Beijing, China, People's Republic of

The percentage changes of the ADC in GIST after two weeks of targeted therapy exhibited reliable performance in response prediction, and these variables outperformed T2WI-CNR and the longest diameter. We suggest that patients continue their treatment regimens if the percentage increases in the ADC are no less than 15% after two weeks of therapy. In contrast, if the ADC decreases or exhibits almost no change, then a shortening of the follow-up time intervals is highly recommended to detect possible drug resistance at an early stage.

Prashant Chandrasekharan¹, Ghayathri Balasundaram¹, Amalina Binte Ebrahim Attia¹, Chris Jun Hui Ho¹, Xuan Vinh To¹, Hui Chien Tay¹, Kai Hsiang Chuang¹, and Malini Olivo^1
1A*STAR, Singapore Bio Imaging Consortium, Singapore, Singapore

Quantification of oxygenation or hypoxia in a tumor plays a key role in the treatment response and the overall survival of glioma patient.  This work illustrates a preclinical study with the use of multimodal imaging technique to correlate tumor oxygenation and blood perfusion, as well as to assess the changes involved in the perturbation of the tumor system using a vascular disruptive agent.

David Aramburu Nuñez^1,2, Kathryn Beal³, Vaios Hatzoglou⁴, Andrei Holodny⁴, Ramesh Paudyal¹, Yonggang Lu⁵, Joseph O Deasy¹, and Amita Shukla-Dave^6
1Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ²Department of Radiology, Complutense University, Madrid, Spain, ³Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ⁴Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States, ⁵Radiation Oncology, Washington University, St. Louis, MO, United States, ⁶Medical Physics & Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY, United States

In clinical settings it is essential to accurately assess, whether or not a brain metastasis has been successfully treated or whether the metastasis require additional treatment. This is the first study that evaluated brain metastases with IVIM DW-MRI and DCE-MRI data both pre- and post- stereotactic radiosurgery (SRS). The preliminary results are promising as it will inform the treating physicians at an early time point about which patients will benefit from SRS (or not). The survival status and functional metrics show different trends for both AWD and DOD that need to be validated in larger patient population.

Yann Jamin¹, Evon S.C. Poon², Albert Hallsworth², Hannah Webber², Laura S. Danielson², Dow-Mu Koh¹, Louis Chesler², and Simon P. Robinson^1
1Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom, ²Division of Cancer Therapeutics and Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom

In this study we demonstrate that T₁ provides a non-invasive biomarker of response to MLN8237, a potent Aurora A kinase inhibitor, in the Th-MYCN genetically-engineered murine model of neuroblastoma, a childhood cancer of the nervous system. Histopathological characterisation demonstrates that T₁ is a generic biomarker of cell death in this model. T₁ quantification in pediatric early-phase clinical trials could potentially help to accelerate the development of urgently needed novel targeted therapies for children with neuroblastoma. 

Chong Duan¹, Carlos J Perez-Torres², Liya Yuan³, John A Engelbach⁴, Christina T Tsien⁵, Keith M Rich^3,5, Robert E Schmidt⁶, Joseph JH Ackerman^1,4,7,8, and Joel R Garbow^4,8
1Chemistry, Washington University in St. Louis, St. Louis, MO, United States, ²Radiological Health Sciences, Purdue University, West Lafayette, IN, United States, ³Neurosurgery, Washington University in St. Louis, St. Louis, MO, United States, ⁴Radiology, Washington University in St. Louis, St. Louis, MO, United States, ⁵Radiation Oncology, Washington University in St. Louis, St. Louis, MO, United States, ⁶Neuropathology, Washington University in St. Louis, St. Louis, MO, United States, ⁷Medicine, Washington University in St. Louis, St. Louis, MO, United States, ⁸Alvin J Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO, United States

Recently, radiation necrosis (RN) has been treated clinically using bevacizumab, an anti-VEGF antibody. While bevacizumab reduces radiographic RN volume, the treatment has potentially serious complications and rebound phenomena after the discontinuation of the therapy. In the present study, we investigated the anti-VEGF treatment of pure radiation necrosis in a mouse model. Favorable radiographic appearance of RN were observed following the anti-VEGF treatment. However, the lesions were not completely resolved histologically (e.g., focal mineral deposits were observed in the treated mice). In addition, despite the treatment, VEGF and HIF-1α were still upregulated, which presents the potential risk of recurrence of RN.