51st AAPM Annual Meeting
Elizabeth Bullitt MD, University of North Carolina-CH, Chapel Hill, NC, 27599-7060, US
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AbstractID: 12140 Title: Noninvasive monitoring of brain tumor therapy
Monitoring the efficacy of brain tumor therapy is a clinical dilemma. Results of biopsy
provide the most reliable indicator but biopsy is too invasive for frequent use. The
clinical standard of practice is to perform serial magnetic resonance scans and to assess
changes to tumor “size” as seen on gadolinium enhanced images, with “size” measured in
one, two, or three dimensions. This review discusses the advantages and disadvantages of
the three measurement methods as well as some of the effects of voxel size on the
calculation. Problems inherent to the use of gadolinium enhanced images include the
effect of steroids and the confounding appearance of radiation necrosis. The limitations
of the approach have led multiple groups to explore alternative methods of assessing
1) Understand the clinical standard of practice of monitoring brain tumor therapy
from T1 gadolinium enhanced images and its strengths/weaknesses.
2) Understand some of the different experimental approaches, often involving
different image types, to assessing tumor activity.
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