Sci‐YIS Fri ‐ 08: Regional change in brain perfusion after fractionated stereotactic radiotherapy (FSRT) at 4 months and 3 years follow‐up

Abstract

Purpose: The change in hemodynamic parameters, such as mean transit time and cerebral blood volume, reflect the damage to vasculature. A relationship between the change in hemodynamic parameters and radiation dose delivered would help predict the degree and nature of damage, and would be most beneficial for patients with a long life‐expectancy who are at risk of long‐term radiation‐induced injury. Method and Materials: We applied the relative perfusion weighted MRI technique, currently used in stroke imaging, to calculate the relative regional mean transit time (rrMTT) and relative regional cerebral blood volume (rrCBV). We acquired data for one patient. We used a 3.0 T magnet at the Seaman Family MRI Centre in Calgary and a single‐shot echo‐planar imaging (EPI) sequence following the injection of a paramagnetic contrast agent (Gd‐DTPA‐Magnevist; Berlex, Wayne, NJ). These images have been processed to yield rrMTT and rrCBV. The patient had previously been treated with surgery, but had received no chemotherapy. The percentage change in rrMTT and rrCBV was correlated to the spatial distribution of radiation dose delivered using the Pinnacle® radiation treatment planning system. Results: Our preliminary results show that with a follow‐up time of 4 months and 3 years after receiving approximately 5000 cGy/25 fractions, rrMTT and rrCBV change significantly in normal tissue and tumour. The most important normal tissue changes occur in the near‐target area. Conclusion: The change in rrMTT and rrCBV indicates response to treatment. Perfusion weighted MRI can be used to assess the change in hemodynamic measures after radiotherapy.