Peter Sherman LaViolette1, Alex D. Cohen1,
Scott D. Rand2, Wade Mueller3, Kathleen M. Schmainda2
1Biophysics, Medical
College of Wisconsin, Milwaukee, WI, United States; 2Radiology, Medical
College of Wisconsin, Milwaukee, WI, United States; 3Neurosurgery,
Medical College of Wisconsin, Milwaukee, WI, United States
The detection of invading brain tumor cells, beyond the traditional contrast-enhancing regions, continues to be a challenge for the treatment of brain tumors. While areas of FLAIR enhancement represent vasogenic edema, some regions are thought to contain invading brain tumor cells. We have observed that regions of heightened FLAIR do not necessarily correspond to regions of heightened ADC expected from increased extracellular fluid. In fact in some cases, heightened FLAIR corresponds to a lower ADC value, what we refer to here as an ADC-FLAIR mismatch, i.e. low ADC within high FLAIR signal. We hypothesize that these regions are potentially indicative of brain tumor invasion. In this study we measure ADC-FLAIR mismatch excluding enhancement (AFMEE) in invasive and non-invasive brain tumor phenotypes.