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BIOM-51. IDENTIFICATION OF A LOW-FLIP ANGLE BASED CBV THRESHOLD FOR FRACTIONAL TUMOR BURDEN (FTB) MAPPING IN RECURRENT GLIOBLASTOMA

Title: BIOM-51. IDENTIFICATION OF A LOW-FLIP ANGLE BASED CBV THRESHOLD FOR FRACTIONAL TUMOR BURDEN (FTB) MAPPING IN RECURRENT GLIOBLASTOMA
Authors: Anil, Aliya; Stokes, Ashley; Alhilali, Lea; Karis, John; Bell, Laura; Eschbacher, Jennifer; Hu, Leland; Boxerman, Jerrold; Schmainda, Kathleen; Quarles, C
Source: Neuro-Oncology ; volume 25, issue Supplement_5, page v15-v16 ; ISSN 1522-8517 1523-5866
Publisher Information: Oxford University Press (OUP)
Publication Year: 2023
Description: INTRODUCTION Differentiation of glioblastoma recurrence from post treatment radiation effects (PTRE) would improve patient management. Dynamic susceptibility contrast (DSC) MRI can be used to generate fractional tumor burden (FTB) maps, via application of regional cerebral blood volume (RCBV) thresholds, to spatially differentiate recurrence from PTRE. FTB maps derived from a DSC-MRI protocol that includes a contrast agent preload in addition to the bolus injection and a moderate-flip angle (MFA) been histologically validated. Recently, a single-dose, low-flip angle (LFA) protocol was shown to provide RCBV measurements consistent with the MFA protocol and has been recommended as a consensus protocol. This study aims to identify the RCBV thresholds for the single-dose, LFA protocol that generates FTB maps, concordant with those obtained from the reference double-dose, MFA protocol. METHODS Two sets of DSC-MRI data were collected sequentially from 52 patients using a single-dose, low-flip angle (30o) protocol and a double-dose, moderate flip angle (60o) protocol using TR = 1.5s and TE = 30ms. Standardized RCBV maps (sRCBV) were obtained and co-registered with the post-contrast T1-weighted images using the FDA-approved clinical software, IB Neuro™ and IB Delta Suite™, respectively. The ground truth MFA-based FTB maps were computed using multiple sRCBV thresholds (1.0 and 1.75). An ROC analysis was conducted to identify the optimal, voxel-wise LFA sRCBV thresholds to produce FTB maps that best match the reference maps. RESULTS/ CONCLUSIONS The ROC analysis identified a lower LFA threshold of 1.0 to accurately distinguish PTRE from tumor recurrence and an upper threshold of 1.55 to differentiate aggressive tumor regions. The single-dose, LFA protocol eliminates variations in the contrast agent incubation time between the preload and bolus injection. This study provides motivation for the use of the single-dose LFA protocol in the management of patients with glioblastoma and is a reliable method for ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/neuonc/noad179.0062
Availability: https://doi.org/10.1093/neuonc/noad179.0062; https://academic.oup.com/neuro-oncology/article-pdf/25/Supplement_5/v15/53255799/noad179.0062.pdf
Rights: https://academic.oup.com/pages/standard-publication-reuse-rights
Accession Number: edsbas.B8F34C0C
Database: BASE