Differentiating radiation effect and necrosis from tumor with measures of normalized and standardized relative cerebral blood volume
Melissa A Prah 1 , Mona M Al-Gizawiy 1 , Wade M Mueller 2 , and Kathleen M Schmainda 1,3
Radiology, Medical College of Wisconsin,
Milwaukee, WI, United States,
Medical College of Wisconsin, Milwaukee, WI, United
Biophysics, 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.
Relative cerebral blood volume measures have shown
promise in differentiating radiation necrosis and tumor.
Through pre-surgical imaging and spatially correlated
biopsy samples, this work demonstrates that both
normalized and standardized relative cerebral blood
volume measures can distinguish radiation necrosis from
tumor with equally high sensitivity and specificity. The
results of this study may be useful for the creation of
tumor burden maps, which could ultimately affect the
course of patient treatment.
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