Volume MRI and MRSI techniques for the quantitation of treatment response in brain tumors: Presentation of a detailed case study
Corresponding Author
Sarah J. Nelson PhD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143Search for more papers by this authorStephen Huhn MD
Department of Neurological Surgery, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorDaniel B. Vigneron PhD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorMark R. Day PhD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorLawrence L. Wald PhD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorMichael Prados MD
Department of Neurological Surgery, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorSusan Chang MD
Department of Neurological Surgery, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorPhilip H. Gutin MD
Department of Neurological Surgery, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorPenny K. Sneed MD
Department of Radiation Oncology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorLynn Verhey PhD
Department of Radiation Oncology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorRandall A. Hawkins MD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorWilliam P. Dillon MD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorCorresponding Author
Sarah J. Nelson PhD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143Search for more papers by this authorStephen Huhn MD
Department of Neurological Surgery, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorDaniel B. Vigneron PhD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorMark R. Day PhD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorLawrence L. Wald PhD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorMichael Prados MD
Department of Neurological Surgery, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorSusan Chang MD
Department of Neurological Surgery, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorPhilip H. Gutin MD
Department of Neurological Surgery, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorPenny K. Sneed MD
Department of Radiation Oncology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorLynn Verhey PhD
Department of Radiation Oncology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorRandall A. Hawkins MD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorWilliam P. Dillon MD
Department of Radiology, Box 1290, University of California, San Francisco, CA 94143
Search for more papers by this authorAbstract
Patients with primary brain tumors may be considered for several different treatments during the course of their disease. Assessments of disease progression and response to therapy are typically performed by visual interpretation of serial MRI examinations. Although such examinations provide useful morphologic information, they are unable to reliably distinguish active tumor from radiation necrosis. This poses a particular problem in the assessment of response to localized radiation therapies such as gamma knife radiosurgery. In this paper, we present methodology for evaluating changes in tissue morphology and metabolism based on serial volumetric MRI and magnetic resonance spectroscopic imaging (MRSI) examinations. Registration and quantitative analysis of these data provide measurements of the temporal and spatial distributions of gadolinium enhancement and of N-acetylasparate, choline, creatine, and lactate/lipid. The key features of this approach and the potential clinical benefits are illustrated by a detailed analysis of six serial MRI/MRSI examinations and three serial 1-[F-18] fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) studies on a patient with a recurrent anaplastic astrocytoma.
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