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Methods To Differentiate Radiation Induced Necrosis And Recurrent Disease In Gliomas

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Methods to Differentiate Radiation Induced Necrosis and Recurrent Disease in Gliomas Lars Ewell University of Arizona Medical Center Department of Radiation Oncology MRI Research Group 2/2/07
Methods to Differentiate Radiation Induced Necrosis and Recurrent Disease in Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Radiation Induced Necrosis ,[object Object],[object Object],[object Object]
Radiation Dose ,[object Object],[object Object],[object Object],[object Object],• Dose  with the energy imparted by ionizing radiation to material of mass .
Radiation Damage: Cell Survival ,[object Object],10 0 10 -1 10 -2 Surviving Fraction Radiation Dose (Gy) 4 8 12 ,[object Object]
Radiation Damage: Early - Late ,[object Object],[object Object],[object Object]
RIN/Recurrent Disease ,[object Object],[object Object],[object Object],Kumar et al., Radiology, 217 , 2, November 2000.
RIN/Recurrent Disease: Comparison ,[object Object],[object Object],[object Object],[object Object],[object Object],Similarities: Differences:
DWMRI to Distinguish RIN and Recurrent Disease ,[object Object],[object Object],[object Object]
Magnetic Resonance Spectroscopy ,[object Object],[object Object],[object Object]
MRS Metabolites ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],MRS Metabolite Ratios * * Weybright et al., Neuroradiology (2004) 46: 541–549 *
Magnetic Resonance Spectroscopy Cho Cr NAA
MRS ,[object Object],[object Object],[object Object],[object Object]
MRS: Normal vs. Disease Voxel # 7 - Normal Voxel # 2 - Disease
MRS: Pre vs. Post Gd Pre Gd Post Gd
Magnetic Resonance Spectroscopy ,[object Object],[object Object]
Arizona Biomedical Research Commission ,[object Object],[object Object]
Imaging Protocol ,[object Object],[object Object],[object Object]
Imaging Protocol: Enrollment Criteria ,[object Object],[object Object],[object Object],[object Object]
Imaging Protocol: Enrollment Criteria Radiation Type Number of Fractions Minimum Radiation (Gy)       SRS 1 21 Hypo-fraction 5 30 Normal Fraction 30 60 Re-treatment varies varies
Imaging Protocol: Imaging Sequence Time from End of Radiotherapy (days) Scans Performed Comments -5 CT, MRI, DWMRI, MRS Baseline scans. Used to plan radiotherapy. CT and MRI registered using Brainscan. 30 MRI, DWMRI, MRS First scan for comparison. 90 MRI, DWMRI, MRS Second scan for comparison. Potential radiation necrosis. Check ADC W for change.
Imaging Protocol ,[object Object],[object Object],[object Object],[object Object]
Imaging Protocol ,[object Object],[object Object],[object Object],[object Object]
Imaging Protocol ,[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object]
Acknowledgement ,[object Object],[object Object],[object Object],[object Object],[object Object]

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radiotherapy of bone metastases,Vakalisfondas vakalis
 
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Vakalis - RT for prostate cancer
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Her2 positive metastatic breast ca
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Advanced breast cancer
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Second line therapy for nsclc
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Methods To Differentiate Radiation Induced Necrosis And Recurrent Disease In Gliomas

  • 1. Methods to Differentiate Radiation Induced Necrosis and Recurrent Disease in Gliomas Lars Ewell University of Arizona Medical Center Department of Radiation Oncology MRI Research Group 2/2/07
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  • 15. MRS: Normal vs. Disease Voxel # 7 - Normal Voxel # 2 - Disease
  • 16. MRS: Pre vs. Post Gd Pre Gd Post Gd
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  • 21. Imaging Protocol: Enrollment Criteria Radiation Type Number of Fractions Minimum Radiation (Gy)       SRS 1 21 Hypo-fraction 5 30 Normal Fraction 30 60 Re-treatment varies varies
  • 22. Imaging Protocol: Imaging Sequence Time from End of Radiotherapy (days) Scans Performed Comments -5 CT, MRI, DWMRI, MRS Baseline scans. Used to plan radiotherapy. CT and MRI registered using Brainscan. 30 MRI, DWMRI, MRS First scan for comparison. 90 MRI, DWMRI, MRS Second scan for comparison. Potential radiation necrosis. Check ADC W for change.
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