ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Scientific Session • Brain Tumor Imaging - Focus on Treatment

Monday 1 June 2015

Constitution Hall 107

10:45 - 12:45


Janine M. Lupo, Ph.D., T.B.A.

10:45 0065.   MRI Tracked Tumor Physiology in the Hours after 20 Gy Single-Fraction Radiation
Rasha M. Elmghirbi1,2, Stephen L. Brown3, Tavarekere N. Nagaraja4, Madhava P. Aryal2,5, Kelly Ann Keenan4, Swayamprav Panda2, Hassan Bagher-Ebadian2, and James R. Ewing1,2
1Physics, Oakland University, Rochester, MI, United States, 2Neurology, Henry Ford Health System, Detroit, MI, United States, 3Radiation Oncology, Henry Ford Health System, Detroit, MI, United States, 4Anesthesiology, Henry Ford Health System, Detroit, MI, United States, 5Radiation Oncology, University of Michigan, Ann Arbor, MI, United States

The acute response in a U251 rat model of embedded cerebral tumor high-dose radiotherapy (HD-RT) is studied by measuring blood flow and vascular parameters in the tumor, and tissue compression in the periphery of the tumor. At 2 and 4 hours post HD-RT a profound decrease in tumor blood flow accompanies a significant decrease in extracellular space in both the tumor and its periphery. Decoupling of tissue compression and blood flow occurs about 8 hours after HD-RT.

10:57 0066.   
Application of 3D High-resolution Multi-echo TOF-SWI Acquisition in Radiation-induced Cerebral Microbleeds at 3T
Xiaowei Zou1, Wei Bian2, Jonathan I. Tamir3, Suchandrima Banerjee4, Susan M. Chang5, Michael Lustig3, Sarah J. Nelson1, and Janine M. Lupo1
1University of California San Francisco, San Francisco, California, United States, 2Radiology, Stanford University, Stanford, California, United States,3Electrical Engineering and Computer Science, University of California Berkeley, Berkeley, CA, United States, 4Global Applied Science Laboratory, GE Healthcare, Menlo Park, CA, United States, 5Neurological Surgery, University of California San Francisco, San Francisco, CA, United States

Radiation therapy is a widely utilized treatment for gliomas. However, it can result in collateral injury to normal-appearing brain tissue, such as the formation of cerebral microbleeds (CMBs). The ability to assess characteristics of CMBs in conjunction with the surrounding arterioles and venules would help to identify underlying vascular injury. In this study, a seven-echo sequence was implemented and optimized for multi-echo multi-contrast high-resolution vascular imaging at 3T within a clinically feasible scan time. The fitted R2* maps can differentiate small-size CMBs and cystic changes, demonstrating the potential benefit of this sequence in routine clinical evaluation of CMBs.

11:09 0067.   
Differentiation Between Progressive Disease and Treatment Necrosis in Patients with Glioblastoma using Dynamic Contrast Enhancement MRI
Moran Artzi1,2, Gilad Liberman1,3, Guy Nadav1,4, Deborah T Blumenthal5, Felix Bokstein5, Orna Aizenstein1, and Dafna Ben Bashat1,6
1Functional Brain Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,3Department of Chemical Physics, Weizmann Institute, Rehovot, Israel, 4Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel, 5Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, 6Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel

Differentiation between progressive-disease (PD) and treatment-necrosis (TN) in patients with Glioblastoma remains a major clinical challenge. In this study the enhanced tumor area was automatically identified from the raw DCE data using ICA. Voxel-based classification was performed using SVM based on the DCE pharmacokinetic parameters in eighteen patients scanned longitudinally (total of 60 MRI scans). Significant differences were obtained between transfer-constants, plasma-volume and bolus-arrival-time in the different tissue classes (PD and TN), and compared to NAWM. High sensitivity (89.3%) and specificity (89.4%) were obtained using two-fold cross-validation design. Classification results were validated by a senior neuro-radiologist and supported by MRS.

11:21 0068.   Dose and Volume Effects of Radiation on White Matter in Children Treated for Medulloblastoma - permission withheld
Iska Moxon-Emre1,2, Eric Bouffet1, Michael D Taylor1,2, Normand Laperriere2,3, Michael Sharpe2,3, Suzanne Laughlin1, Nadia Scantlebury1, Nicole Law1,2, David Malkin1,2, Jovanka Skocic1, Logan Richard1,2, and Donald Mabbott1,2
1Hospital for Sick Children, Toronto, Ontario, Canada, 2University of Toronto, Toronto, Ontario, Canada, 3University Health Network, Toronto, Ontario, Canada

This study examined white matter (WM) in children treated for medulloblastoma with different clinically relevant radiation dose and boost volumes, using diffusion tensor imaging (DTI). We found that relative to controls, patients treated with higher doses and/or larger boost volumes show more compromised WM than patients treated with the least intensive therapy (i.e. reduced dose CSR and a boost limited to the tumor bed). This was particularly evident in the temporal lobes, a brain region encompassed by a lateral beam boost to the posterior fossa (PF). Our findings suggest the PF boost should be avoided whenever possible.

11:33 0069.   The Effect of Systemic Chemotherapy on White Matter Tracts Involved with Cognition in Children with NF1-Associated Optic Pathway Gliomas
Peter MK de Blank1, Michael J Fisher2, Timothy PL Roberts2, and Jeffrey I Berman2
1UH Case Medical Center, Cleveland, OH, United States, 2The Children's Hospital of Philadelphia, PA, United States

Although chemotherapy has been associated with cognitive deficits and changes in white matter integrity, the effect of low-intensity chemotherapy (separate from surgery and radiation) has not been examined. We examined diffusion tensor imaging (DTI) in 12 age-matched pairs of children with neurofibromatosis type 1 and optic pathway glioma with or without exposure to low-intensity chemotherapy, and without exposure to surgery or radiation. Subjects exposed to low-intensity chemotherapy had decreased FA in tracts previously associated with cognitive deficits. Two subjects with DTI scans before and after exposure to chemotherapy showed decrease in FA over 1 year.

11:45 0070.   Comparison of diffusion and perfusion parameters in distinguishing radiation effect and necrosis from GBM - permission withheld
Melissa A Prah1, Mona M Al-Gizawiy1, Wade M Mueller2, Raymond G Hoffmann3, Mahua Dasgupta3, and Kathleen M Schmainda1,4
1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States, 2Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States,3Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States, 4Biophysics, Medical College of Wisconsin, Milwaukee, WI, United States

In brain tumor patients, pseudoprogression, which results from an inflammatory response associated with necrotic and radiation induced changes, has been shown to mimic early tumor progression on standard imaging. The goal of this study was to compare the ability of diffusion and perfusion parameters in differentiating radiation effect/necrosis (RE/Necrosis) from glioblastoma (GBM). Using tissue samples spatially-correlated to pre-surgical imaging, this work demonstrates that relative cerebral blood volume (rCBV) better distinguishes RE/Necrosis from GBM than relative cerebral blood flow or the apparent diffusion coefficient. Spatially visualizing differentiated regions of RE/Necrosis and GBM with rCBV may ultimately impact treatment management decisions.

11:57 0071.   Tissue Mapping in Brain Tumors with Partial Volume Magnetic Resonance Fingerprinting (PV-MRF)
Anagha Deshmane1, Chaitra Badve2, Matthew Rogers3, Alice Yu3, Dan Ma1, Jeffrey Sunshine2, Vikas Gulani2, and Mark Griswold2
1Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States, 2Radiology, University Hospitals, Cleveland, OH, United States, 3School of Medicine, Case Western Reserve University, Cleveland, OH, United States

Magnetic resonance fingerprinting (MRF) can be used to simultaneously map T1, T2 and off-resonance. It was previously demonstrated that modeling single voxel MRF signals as a weighted sum of evolutions from known tissue types can be used to quantify subvoxel tissue fractions in the brain and perform tissue segmentation. Here MRF is used to estimate fractions of free fluid, intra/extracellular water, and myelin water in brain tumor patients with glioblastoma multiforme and metastases. A significant difference in free fluid and intra/extracellular water fraction was found in perilesional white matter between the two patient groups.

12:09 0072.   Parameterization of delayed contrast enhancement maps for the depiction of necrosis in glioblastoma
Mary A McLean1, Stephen J Price2, Ferdia A Gallagher3, and John R Griffiths1
1Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, 2Dept of Neurosurgery, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom, 3Dept of Radiology, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom

We investigated relationships between MR measures of perfusion, diffusion, T2-hyperintensity, and metabolite content in 7 newly-diagnosed gliomas at 3T. Parameterized subtraction maps of high-resolution T1-weighted images obtained ~5 and ~50 min after gadolinium injection showed a non-enhanced tumour core, correlating positively with lactate and negatively with creatine and choline, as distinct from a late-enhancing area which had a metabolic profile more similar to active tumour. ADC and T2-hyperintensity correlated with each other but not with either MRS or perfusion. Maps of delayed enhancement may provide a useful high-resolution surrogate for metabolic information, but further validation is needed.

12:21 0073.   Abnormal Tumor and Peritumor Vasculature and Metabolism Differentiate Primary from Metastatic Brain Tumors
Ingrid Digernes1, Frédéric Courivaud1, Cathrine Saxhaug2, Marco C. Pinho3, Oliver M. Geier1, Einar Vik-Mo4, Knut Haakon Hole5, Grete Lovland1, Svein Are Vatnehol1, Torstein R. Meling4, Otto Rapalino6, Atle Bjornerud1,7, and Kyrre E. Emblem1
1The Intervention Centre, Oslo University Hospital, Oslo, Oslo, Norway, 2Department of Radiology, Oslo University Hospital, Oslo, Norway, 3Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75235, United States, 4Department of Neurosurgery, Oslo University Hospital, Oslo, Norway, 5Departement of Radiology, Oslo University Hospital, Oslo, Norway, 6Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, United States, 7Department of Physics, University of Oslo, Oslo, Norway
We have used Vessel Architectural Imaging to reveal mechanisms of vascular remodelling in tumor and regions of peritumoral edema by comparing results from gliobastomas(GBMs) and metastatic brain tumors(METs). We found that the relative oxygen saturation level in tumor and edema regions were significantly higher in GBMs compared to METs and that vessel calibres of GBMs were larger than those of METs in tumor. This suggests that there are marked differences in tumoral and peritumoral vascular microenvironments in primary and metastatic brain tumors and that advanced MRI techniques may give valuable insights into the mechanisms of angiogenesis and growth in brain tumor patients.

12:33 0074.   13C MRS of hyperpolarized [1-13C] pyruvate can differentiate between SAHA resistant and sensitive glioblastoma cells
Pia Eriksson1, Myriam M Chaumeil1, Joydeep Mukherjee2,3, Russell O Pieper2,3, and Sabrina M Ronen1,3
1Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States, 2Neurological Surgery, University of California San Francisco, San Francisco, CA, United States, 3Brain Tumor Research Center, University of California San Francisco, CA, United States

Several currently available drugs with clinical relevance to GBM affect pyruvate metabolism. In this study, we show that 13C MRS of hyperpolarized [1-13C] pyruvate can also be used to evaluate response to the previously unexplored drug SAHA in glioblastoma cells. In GBM14 SAHA-sensitive cells, a drop in hyperpolarized [1-13C] pyruvate to [1-13C] lactate conversion was observed after SAHA treatment, while it remained unchanged in SAHA-resistant cells. Furthermore, hyperpolarized [1-13C] lactate levels were significantly different between sensitive and resistant cells both pre- and post-treatment, indicating that this metabolic imaging technique might also have prognostic value.