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Abstract #1720

Towards MRI Differentiation of Recurring Tumor from Delayed Radiation Necrosis

Carlos J. Perez-Torres1, John A. Engelbach1, Jeremy Cates2, Dinesh K. Thotala2, Robert E. Drzymala2, Joseph J.H. Ackerman3, 4, Joel R. Garbow1

1Department of Radiology, Washington University in Saint Louis, Saint Louis, MO, United States; 2Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, MO, United States; 3Department of Radiology, Washington University in St. Louis, Saint Louis, MO, United States; 4Department of Chemistry, Washington University in Saint Louis, Saint Louis, MO, United States


Standard anatomical MRI is incapable of differentiating recurring tumor from delayed radiation necrosis, as both lesions are hyperintense. The work presented here investigates mouse models of radiation necrosis and brain tumor with more advanced MRI methodologies, including diffusion-weighted imaging (DWI) and magnetization transfer contrast (MTC). Both tumor and necrosis showed decreases in MTR, with the MTC effect being stronger for tumor than radiation necrosis. The ADCi for tumor was similar to that of healthy brain, while ADCi was elevated in necrosis. A multi-contrast approach that includes both modalities might lead to a framework for differentiating between these pathologies.