ESTRO 2025 - Abstract Book

S3868

Physics - Radiomics, functional and biological imaging and outcome prediction

ESTRO 2025

Conclusion: Our study proposes leveraging perfusion-weighted MRI to achieve improved case stratification versus historical image-based protocols. Preliminary results suggest that DCE-derived parameters can accurately distinguish TP from RN. However, an increased sample size is required to confirm the robustness of these findings.

Keywords: brain metastases, perfusion, radionecrosis

References: 1. Patel, T. R. et al. A Comprehensive Review of MR Imaging Changes following Radiosurgery to 500 Brain Metastases. Am. J. Neuroradiol. (2011). 2. Minniti, G. et al. Stereotactic radiosurgery for brain metastases: analysis of outcome and risk of brain radionecrosis. Radiat. Oncol. Lond. Engl (2011). 3. Detsky, J. S. et al. Differentiating radiation necrosis from tumor progression in brain metastases treated with stereotactic radiotherapy: utility of intravoxel incoherent motion perfusion MRI and correlation with histopathology. J. Neurooncol. (2017). 4. Telera, S. et al. Radionecrosis induced by stereotactic radiosurgery of brain metastases: results of surgery and outcome of disease. J. Neurooncol. (2013).

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Mini-Oral Functional Connectivity Changes of IDH-mutant and IDH-wildtype Glioma Patients using Aberrancy Parcel Analysis of Resting-state Functional MRI Zhihua Liu 1 , Kay Park 2 , Timothy Mitchell 1 , Chongliang Luo 3 , Joshua Shimony 4 , Robert Fucetola 5 , Abraham Snyder 4 , Jiayi Huang 1 , Tong Zhu 1 1 Radiation Oncology, Washington University School of Medicine, St Louis, USA. 2 Neurological Surgery, Washington University School of Medicine, St Louis, USA. 3 Surgery, Washington University School of Medicine, St Louis, USA. 4 Radiology, Washington University School of Medicine, St Louis, USA. 5 Neruology, Washington University School of Medicine, St Louis, USA Purpose/Objective: This prospective observational study investigates aberrant changes in brain functional connectivity (FC) in glioma patients compared to normal controls after radiotherapy (RT). We aim to identify not only subject-specific connectivity disruptions but also dominant network-level disturbances among tumor patients that correlate with neurocognitive function (NCF) changes post-RT. Material/Methods: 35 adult patients with gliomas underwent NCF testing using the NIH Toolbox Cognitive Function Battery (NIHTB-CFB) at baseline and 6 months post-RT. The scores from the five fluid cognition tests were combined into an age normalized composite score, from which the percent change of composite (PCC) was calculated relative to the baseline. Resting-state fMRI (rs-fMRI) was acquired over 12 minutes on 3-Tesla MRI coinciding with each NCF test. To quantify tumor- and treatment-induced changes in brain FC, aberrancy parcel maps (APM, Fig.1A) were generated for each patient by comparing the pattern of FC within each of 1000 gray matter (GM) parcellation to those from 136 age- and gender-matched normal subjects [1] through a rigorous Kolmogorov-Smirnov test.